Many countries, especially major superpowers such as China and the United States, are constantly looking for more cost-effective solutions to meet their inhabitants' healthcare demands. The Chinese government announced plans in April 2009 to provide economical, safe, and efficient healthcare services by 2020. Initially, the government provided its inhabitants with free health care (World Health Report 10). The cost-efficiency and ability to pay for health care are the most important variables to consider. The report analyzes the demographic segment covered, the services provided, and the associated expenditures in this analysis.
Around 95% of China's population has access to basic health care and insurance. However, insurance covers about half of the total medical costs. The government requires that insurance is increased in order to cover 70 percent of the costs by 2017. The number of hospital beds per an estimated 1000 people in China reached 4.2; a value higher than the average 3.7 for upper and middle income countries (World Health Report 12). However, China is short of qualified doctors with an estimate of 1.4 physicians per a population of 1,000. According World Bank Statistics, the average value for middle-income countries is estimated at 1.7 physicians for every a 1000. The number of nurses per a population of 1,000 is estimated at 1.4; which is also lower compared to the value in middle level economies (World Health Organization 23).
Services offered
Healthcare services in China are provider by both public and private sectors. The Chinese government delivers highly specialized public services such as disease prevention services. On the other hand, the private industry provides outpatient and inpatient services, secondary and tertiary services.
Inpatient and Outpatient Services
Outpatient services protects the consumer from everyday healthcare expenses. Some of the services covered under outpatient care include diagnostics, routine health check-ups, prescriptions, alternative therapy treatments and vaccinations.
Inpatient insurance coverage protects one from costs of medical treatment in case of an overnight stay. Some of the services include ambulance transportation, surgical anesthetics, intensive care facilities, private and semi-private hospital rooms, diagnostics, x-ray services and medications required when one is an inpatient (Braithwaite et al. 8).
Health promotion and Disease prevention
The center for Health protection is charged with provision of emergency preparedness and management of health crises. Works on laboratory service, infection control and health protocols are all provided by under this service.
Secondary and Tertiary services
The government provides specialized accident, multi-specialty acute cases, emergency services and extended tertiary services. Other services under this category includes transplants, surgery and treatment of life threatening diseases.
Traditional chines medicine
These services make a major contribution to the Chinese healthcare sector. It is used as a prevention and treatment mechanism. These services includes acupuncture, manual therapies and herbal medicines (Braithwaite et al. 16).
Increase in demand for the services over the last decade are illustrate illustrated in the graph below:
National Bureau of Statistics (Braithwaite et al. 17)
Costs Covered
From the ShowMe audio and video, it is evident that there are a number of methods considered in realizing the objective of financing payment of healthcare services. Three types of cost coverage explained includes direct payments, insurance (pooling) and external assistance. Between 2009 and 2011, China carried out a 3 year plan and it injected an estimated Y 283 Billion in a bid to build 2800 county hospitals. According to WHO (2016), the country’s expenditure on health will grow from the current $ 782 Billion to 2018’s value of 852 Billion.
Ways in which China pays for Health Coverage
Insurance (Pooling)
It is the most used method of financing China’s universal healthcare coverage. It is sub-divided into medical insurance for urban residents, urban employees and rural insurance coverage. In China, tax financing has proved to be progressive as it funds healthcare system in China. Indirect taxation is the biggest contributor to these costs. It is born by everyone including the poor, middle class and rich (ShowMe). The more people who share the financial risk, the lower risk for an individual requiring healthcare services. Government backed insurance and private insurance has been key in coverage of healthcare in China. For instance, premium levels increased from Yuan 60 Billion in 2011 to Yuan 400 Billion in 2015. The number of premium levels increased from 60 million contributions to 160 million within the mentioned time span. Within this period, reimbursement levels increased from 759 million citizens to 1087 million. Therefore the population coverage was almost doubled within this span of time (World Health Report 8). 58 percent of these individuals were outpatients while 75 % of the amounts covered inpatient care. According to China’s National Bureau of statistics, the total financing from insurance increased from 2047.6 per head to 3025.3 in 2014 (Braithwaite et al. 34). The expenditure followed the same trend as shown in the graph below.
Graph of Insurance Contributions against total Financing and Expenditure
National Bureau of Statistics (Braithwaite et al. 17)
However, with respect to rural health insurance, individual contribution were at a minimal due to difficulties associated with socio-economic status (Braithwaite et al. 17).
Direct payments
Majority of the poor people and outpatients use this form payment. This method is a vicious cycle because it forces individuals to pay despite their impoverished status. In 2008-2009, out of pocket expenditure covered 35.4 percent of the total expenditure. However, this payment method has decreased in the past half-decade due to the increase healthcare coverage by the government (Braithwaite et al. 8). However, most out of pocket spending is on prescription drugs. Reimbursements are lower in outpatient care than in inpatient. In 2013, the values were $ 820 for outpatients and $ 49180 for inpatient care.
External Assistance
This is a way of raising funding through donors and grants. This can be done through direct funding or through establishment of pool of funds in the specific countries. China rarely receives external assistance due to its developed-economy status. Study by World Health Organization (2016) shows that OECD countries (including China) contribute an estimated $ 21.8 Billion to lesser-privileged countries.
Conclusion
As this report shows, health finance reform is taking place in many countries, specifically in China and it impacts on many levels of economic development. However, there is no prefixed set formula for achieving universal coverage. The paper analyses the costs covered, services offered and the range of population covered by healthcare services.
References
Braithwaite, Jeffrey, Yukihiro Matsuyama, Russell Mannion, and Julie K. Johnson. Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships, and Prospects in 30 Countries. , 2015. Print.
ShowMe. Premium. Health financing. (2016). Retrieved from: http://www.showme.com/sh/?h=cR7aAxU
World Health Organization. World health statistics. Geneva. 2010
World Health Report: Health Systems Financing: The Path to Universal Coverage. Executive Summary. (2010)
