China went through a drastic change in 1978 from communism to a better economic change by Deng Xiaoping. He ushered china into new era. Even though he made huge reforms economically, China was lacking any significant reforms in medical systems. China prior to 1978 had a centralized medical system. Now its split between private and public services. China’s public healthcare is inconsistent. The developed and established cities have easy and direct access to hospitals and lot of advanced medical services but the rural areas and towns don’t have even basic medical needs. The quality in some health care facilities is up to Western standards even though their methods are different. (Gao,chen,4). Health care system is divided into government and private sector.
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Government provided majority of healthcare infrastructure and private sector provided majority of health funding. China urban health care system implemented new Basic Medical Insurance system (BIS) for urban employees, co-funded by employer and employee. Also, launched pilot projects to cover urban residents even outside workforce. Rural Health care system was also started consists of new co-operative medical health insurance system co-funded by government and rural population. By the end of 2007, NCMS covered 86% or rural population and is target to cover 100% by 2010.
China is one of the fastest ageing countries and has more people aged 65 years. China’s health care system during 1948-1978. Centrally Planned. Health care for all. Reimbursement system. Urban Health Insurance Plans GIS and LIS. Rural Cooperative Medical Scheme (CMS). “Face” of healthcare was barefoot doctor. No private clinics/hospitals. Another reform between 1978- 2000, decentralization – Healthcare responsibility shifted to local bodies. Collapse of traditional healthcare system. Out-of-pocket expenditure increased drastically. Permission granted for profit hospitals and clinics. Between 2000 -2005, merger of GIS and LIS into Basic Urban Employee Health Insurance plan •Rural co-operative medical scheme launched. Commercial insurers allowed to enter market.
And in 2005-2012, healthcare for all. The new health care reforms focused on expanding health insurance coverage and improve healthcare system. The reforms also focused improving the quality in delivery of health services.
China’s elderly population is around 200 million and is increasing but their health-care and facilities are decreasing. Due to lack of health-care 3/4th of their elderly population is suffering from non-communicable diseases. Their health care system is unfair and is not changed according to the meeting needs of new age. Only a small percentage of population is covered by proper health-care. The elderly population has only few nursing homes and rehabilitation services. (Hamed,3)
Moreover, the elderly population have less knowledge about safeties and precautions. Health-care education and promotion of safety guidelines are necessary. Many diseases can be avoided with by properly educating and spreading the safety principles. Public health care funding decreased over the years and at the same time house hold expenditure raised.
China tried to change and improve their health-care system over the years through fee for service plan to reimbursement affects even then the health-care system is under stress. Increasing in the number of aging population and decrease in younger generations will cripple the country in the future. Moreover, the ageing population is a burden on the economy. (Wang, Chen,1). Government Initiatives to Meet Elderly Society Challenge. Implementation of various chronic-disease prevention programs at national level. Local government agencies training laid-off workers in long-term care. New reforms enabled for special geriatric medical training at undergraduate level. The number of geriatric units also are increased. Government and private organization efforts has increased elderly home and gave raise to many new nursing homes. Community based elderly care services were also started in many urban areas. Government has understood the health issues and started to allocate more funds towards improving elderly care.
China’s government health expenditure spending is very low according to international standards per capita expenditure is also low. Between 1987-2007, China has increased its efforts in improving health status of its population. Chronic diseases, non-communicable diseases accounted for 80% deaths. People of china had a high exposure rate to risk factors. Since 2003, many safety precautions and awareness campaigns are lead to protect people from infectious diseases. Health organizations also have focused eradicating water borne illness. Later huge investments were carried out to stop water borne pollution. A new national environmental performance information disclosure program has also been started to improve health care. China’s population relatively young by international standards •However, rapid aging will soon begin in China. China’s one child policy and aging population are creating huge economic and social challenges for society from growing and developing. These are some of the issues that are causing stress on China’s health care system.
References
1) Gao, Chen, Xu, Fei, and Liu, Gordon G. “Payment Reform and Changes in Health Care in China.” Social Science & Medicine 111 (2014): 10. Web.
2) Hamed, Abdula. The Problems of China’s Health Care System Reasons for This Development and Improvement Suggestions. Hamburg: Diplomica Verlag, 2010. Web.
3) Wang, and Chen. “Population Ageing Challenges Health Care in China.”The Lancet 383.9920 (2014): 870. Web.
4) The Lancet. “Ageing in China: A Ticking Bomb.” The Lancet 388.10056 (2016): 2058. Web.
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