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Urban economic reform and access to health care coverage in the People's Republic of China


  • Grogan, Colleen M.


While the economic reforms since 1978 have brought about substantial changes in the rural health care system, there have been many and far-reaching implications for the urban health insurance system as well. This paper describes the evolving urban economy and examines the implications of these changes for access to health care coverage. Provided first is a brief description of the Chinese urban health care system. Three major areas of urban economic reform since 1984 are outlined and the possible effects of these reforms on health care coverage are discussed. The analysis reveals, first, the emergence of insurance coverage inequities under employment-based health insurance as China moves toward a open market economy. Second, the process of focusing on health services in rural and urban areas as separate systems is unnecessary and even counter-productive in light of the emerging integration of China's urban and rural-economies. Finally, some reasons for why China continues to search for employment-based health financing approaches are offered.

Suggested Citation

  • Grogan, Colleen M., 1995. "Urban economic reform and access to health care coverage in the People's Republic of China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1073-1084, October.
  • Handle: RePEc:eee:socmed:v:41:y:1995:i:8:p:1073-1084

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    Cited by:

    1. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    2. Du, Juan, 2009. "Economic reforms and health insurance in China," Social Science & Medicine, Elsevier, vol. 69(3), pages 387-395, August.
    3. David Chu & Kolleen Rask, 2000. "The Transformation of China’s Health Care System and Accounting Methods: Current Reforms and Developments," Working Papers 0003, College of the Holy Cross, Department of Economics.
    4. Liu, Jun-Qiang, 2011. "Dynamics of social health insurance development: Examining the determinants of Chinese basic health insurance coverage with panel data," Social Science & Medicine, Elsevier, vol. 73(4), pages 550-558, August.
    5. Wu, Yanrui, 1997. "China's health care sector in transition: resources, demand and reforms," Health Policy, Elsevier, vol. 39(2), pages 137-152, February.
    6. Wu, Ming & Xin, Ying & Wang, Huihui & Yu, Wei, 2005. "Private and public cross-subsidization: financing Beijing's health-insurance reform," Health Policy, Elsevier, vol. 72(1), pages 41-52, April.
    7. Degeling, Pieter & Zhang, Kai & Coyle, Barbara & Xu, Lingzhong & Meng, Qingyue & Qu, Jiangbin & Hill, Michael, 2006. "Clinicians and the governance of hospitals: A cross-cultural perspective on relations between profession and management," Social Science & Medicine, Elsevier, vol. 63(3), pages 757-775, August.
    8. Teh-Wei Hu & Michael Ong & Zi-Hua Lin & Elizabeth Li, 1999. "The effects of economic reform on health insurance and the financial burden for urban workers in China," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 309-321.
    9. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2), pages 181-188.


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