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Transformation of China's rural health care financing

Author

Listed:
  • Liu, Yuanli
  • Hsiao, William C. L.
  • Li, Qing
  • Liu, Xingzhu
  • Ren, Minghui

Abstract

In the late 1970s China launched its agricultural reforms which initiated a decade of continued economic growth and significant transformation of the Chinese society. The agricultural reforms altered the peasants' incentives, weakened community organization and lessened the central government's control over local communities. These changes largely caused the collapse of the widely acclaimed rural cooperative medical system in China. Consequently China experienced a decreased supply of rural health workers, increased burden of illnesses, disintegration of the three tier medical system, reduced primary health care, and an increased demand for hospital medical services. More than ten years have elapsed since China changed its agricultural economic system and China is still struggling to find an equitable, efficient and sustainable way of financing and organizing its rural health services. The Chinese experiences provided several important lessons for other nations: there is a need to understand the limits of the market forces and to redefine the role of the government in rural health care under a market economy; community participation in and control of local health financing schemes is essential in developing a sustainable rural health system; the rural health system needs to be dynamic, rather than static, to keep pace with changing demand and needs of the population.

Suggested Citation

  • Liu, Yuanli & Hsiao, William C. L. & Li, Qing & Liu, Xingzhu & Ren, Minghui, 1995. "Transformation of China's rural health care financing," Social Science & Medicine, Elsevier, vol. 41(8), pages 1085-1093, October.
  • Handle: RePEc:eee:socmed:v:41:y:1995:i:8:p:1085-1093
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    Citations

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    Cited by:

    1. Liu, Yuanli & Rao, Keqin & Fei, John, 1998. "Economic transition and health transition: comparing China and Russia," Health Policy, Elsevier, vol. 44(2), pages 103-122, May.
    2. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 65-82, July.
    3. Dr B C Purohit, "undated". "Structural Adjustment and the Health Care Sector in India: some policy issues in financing," QEH Working Papers qehwps02, Queen Elizabeth House, University of Oxford.
    4. Huy Van Nguyen & Thi Hong Ngoc Nguyen, 2015. "Factors associated with self-medication among medicine sellers in urban Vietnam," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(3), pages 219-231, July.
    5. Vivian Valdmanis & Arianna DeNicola & Patrick Bernet, 2015. "Public health capacity in the provision of health care services," Health Care Management Science, Springer, vol. 18(4), pages 475-482, December.
    6. Wang, Hong & Zhang, Licheng & Yip, Winnie & Hsiao, William, 2006. "Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China," Social Science & Medicine, Elsevier, vol. 63(5), pages 1236-1245, September.
    7. Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.
    8. 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.
    9. Fitzner, Karen A. & Coughlin, Sheryl & Tomori, Cecilia & Bennett, Charles L., 2000. "Health care in Hong Kong and mainland China: one country, two systems?," Health Policy, Elsevier, vol. 53(3), pages 147-155, October.

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