The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties
AbstractDuring the 1960's and 1970's the Chinese government encouraged the 'rural cooperative medical systems' (RCMS), in order to ensure access to basic health care among the rural population. There was a break in the development of the RCMS in the early 1980's, as a consequence of market economic reforms. These reforms involved a shift from a communal to a household production system. As a result the collective way of financing rural health care was more or less abandoned. However, the government of the People's Republic of China was aware of the need to provide social protection against health care expenses. In March 1994 the government initiated a project to reestablish the RCMS. This project was implemented on a pilot basis in 14 counties of seven provinces. The reestablishment of the RCMS would be guided by the basic principles of health insurance. In October 1995, a first mid-term evaluation of the RCMS Project was held. One of the major research questions concerned the extent to which the RCMS had reduced the risk of paying health care bills that would otherwise be a burden on families. This article addresses this question and assesses the results obtained after two years of RCMS experimental work. A general finding is that the population structure by occupation and income varies, and that the RCMS has adapted itself to this variety. It is also confirmed that the burden of health care costs on families was reduced, more so in some counties than in others, but this reduction has been modest. The research results indicate that there is ample room for improvement. The outlook is hopeful, however. At the national level, there is now systematic thinking about RCMS. The current RCMS work is also having a considerable influence on other counties that are keen to reestablish the RCMS.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 48 (1999)
Issue (Month): 7 (April)
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Wagstaff, Adam & Yu, Shengchao, 2005.
"Do health sector reforms have their intended impacts ? The World Bank's Health VIII project in Gansu province, China,"
Policy Research Working Paper Series
3743, The World Bank.
- Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May.
- Cuong Viet Nguyen, 2012. "The Impact Of Voluntary Health Insurance On Health Care Utilization And Out‐Of‐Pocket Payments: New Evidence For Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 21(8), pages 946-966, 08.
- Liu, Hong & Fang, Hai & Zhao, Zhong, 2013.
"Urban–rural disparities of child health and nutritional status in China from 1989 to 2006,"
Economics & Human Biology,
Elsevier, vol. 11(3), pages 294-309.
- Liu, Hong & Fang, Hai & Zhao, Zhong, 2012. "Urban-Rural Disparities of Child Health and Nutritional Status in China from 1989 to 2006," IZA Discussion Papers 6528, Institute for the Study of Labor (IZA).
- Matthew Jowett, 2004. "Theoretical insights into the development of health insurance in low-income countries," Working Papers 188chedp, Centre for Health Economics, University of York.
- Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009.
"Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme,"
Journal of Health Economics,
Elsevier, vol. 28(1), pages 1-19, January.
- Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
- Devadasan, Narayanan & Ranson, Kent & Van Damme, Wim & Acharya, Akash & Criel, Bart, 2006. "The landscape of community health insurance in India: An overview based on 10 case studies," Health Policy, Elsevier, vol. 78(2-3), pages 224-234, October.
- Wang, H. Holly & Rosenman, Robert, 2007. "Perceived need and actual demand for health insurance among rural Chinese residents," China Economic Review, Elsevier, vol. 18(4), pages 373-388.
- Walaiporn Patcharanarumol & Anne Mills & Viroj Tangcharoensathien, 2009. "Dealing with the cost of illness: The experience of four villages in Lao PDR," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 212-230.
- Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages S7-S23, July.
- Xiaoyun Sun & Sukhan Jackson & Gordon Carmichael & Adrian C. Sleigh, 2009. "Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 103-119.
- Liu, Hong & Gao, Song & Rizzo, John A., 2011. "The expansion of public health insurance and the demand for private health insurance in rural China," China Economic Review, Elsevier, vol. 22(1), pages 28-41, March.
- Xilong Pan & Hassan H. Dib & Minmin Zhu & Ying Zhang & Yang Fan, 2009. "Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1146-1162.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.