The Path to Integrated Insurance Systems in China
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Washington, DC
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Since the 2003 Severe Acute Respiratory
Syndrome (SARS) outbreak, health care in China has become a
leading national concern. Often highlighted by the popular
phrase, kan-bing-nan, kan-bing-gui (seeking care is
difficult and expensive), healthcare costs can be
devastating. Prior to 2007, there were two formal insurance
programs: the Urban Employee Basic Medical Insurance (UEBMI)
for the urban employed population, and the New Rural
Cooperative Medical Insurance (NRCMI) for rural residents. A
third major group-urban resident without formal
employment-was essentially left out of the state health
security system. In July 2007, the State Council initiated a
pilot experiment in 79 cities-the Urban Resident Basic
Medical Insurance (URBMI). The plan targeted urban residents
without formal employment, especially the elderly and
children (State Council 2007). The present health policy
note provides an updated review of healthcare settings and
policy reforms, focusing primarily on urban health
financing. It discusses urban insurance in the context of
universal coverage and how to harmonize insurance schemes
across urban and rural areas. This discussion is placed in
the context of global experience and emerging principles of
best practices.
Palabras clave
ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, ACCESSIBILITY, ADMINISTRATIVE COST, ADMINISTRATIVE COSTS, ADMINISTRATIVE OVERHEAD, ADVERSE SELECTION, AGED, AGING, ALTERNATIVE EMPLOYMENT, BANKRUPTCY, BASIC HEALTH SERVICES, BENEFICIARIES, BENEFIT PAYMENTS, BUSINESS ENTERPRISES, CAPACITY BUILDING, CAPITAL INVESTMENT, CAPITAL STRUCTURES, CAPITATION, CAPITATION PAYMENTS, CITIES, COMMUNITY HEALTH, COST CONTROL, COST-EFFECTIVENESS, COST-SHARING, DEDUCTIBLE, DEDUCTIBLES, DELIVERY OF HEALTH SERVICES, DELIVERY SYSTEM, DELIVERY SYSTEMS, DEMOGRAPHIC CHARACTERISTICS, DENTAL CARE, DIABETES, DOCTORS, ECONOMIC COOPERATION, ECONOMIC DEVELOPMENT, ECONOMIC GROWTH, ECONOMIC REFORM, ECONOMIC REFORMS, ECONOMIC SYSTEM, EFFICIENCY OF PROVIDERS, EMPLOYEE, EMPLOYER, EMPLOYER CONTRIBUTIONS, EMPLOYERS, EMPLOYMENT, EMPLOYMENT STATUS, ENTRY BARRIERS, EQUAL ACCESS, EQUAL TREATMENT, EQUITABLE ACCESS, EQUITY IN ACCESS, ESSENTIAL DRUGS, EXCHANGE RATE, EXPANSION OF COVERAGE, EXPENDITURES, FAMILIES, FEE SCHEDULE, FEE SCHEDULES, FEE-FOR-SERVICE, FEE-FOR-SERVICE PAYMENT, FINANCIAL BURDEN, FINANCIAL BURDENS, FINANCIAL DIFFICULTIES, FINANCIAL DIFFICULTY, FINANCIAL HEALTH, FINANCIAL PROTECTION, FINANCIAL RISK, FINANCIAL RISKS, FINANCIAL SECURITY, FINANCIAL SUSTAINABILITY, FISCAL SUBSIDIES, FISCAL SUBSIDY, GOVERNMENT POLICIES, GOVERNMENT POLICY, HEAD OF HOUSEHOLD, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE EXPENDITURE, HEALTH CARE EXPENDITURES, HEALTH CARE INSTITUTIONS, HEALTH CENTERS, HEALTH CONDITIONS, HEALTH COVERAGE, HEALTH ECONOMICS, HEALTH EXPENDITURE, HEALTH EXPENDITURE PER CAPITA, HEALTH EXPENDITURES, HEALTH EXPENDITURES PER CAPITA, HEALTH FINANCING, HEALTH INSURANCE SCHEMES, HEALTH NEEDS, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROVIDERS, HEALTH REFORM, HEALTH RESOURCES, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH WORKERS, HEALTHCARE EXPENDITURE, HEALTHCARE EXPENDITURES, HEALTHCARE INSTITUTIONS, HEALTHCARE PROVIDERS, HEALTHCARE SYSTEM, HEALTHY DEVELOPMENT, HORIZONTAL EQUITY, HOSPITAL ADMISSION, HOSPITALS, HUMAN RESOURCES, ILLNESS, INCOME COUNTRIES, INCOME GROUPS, INDEMNITY, INDUCED DEMAND, INDUSTRIAL ENTERPRISES, INFLATION, INFORMED CONSENT, INPATIENT CARE, INSURANCE, INSURANCE AGENCIES, INSURANCE AGENCY, INSURANCE CLAIMS, INSURANCE COVERAGE, INSURANCE EXPENDITURES, INSURANCE FUNDS, INSURANCE PLAN, INSURANCE PLANS, INSURANCE POLICIES, INSURANCE POOLS, INSURANCE PREMIUMS, INSURANCE RATE, INSURANCE SYSTEM, INSURANCE SYSTEMS, INTEGRATION, INTERNATIONAL BANK, KEY CHALLENGE, LOW INCOME, MEDICAL COSTS, MEDICAL INSURANCE, MEDICAL INSURANCE COVERAGE, MEDICAL INSURANCE ENROLLMENT, MEDICAL SAVINGS ACCOUNTS, MEDICAL SERVICES, MEDICAL SYSTEM, MEDICAL TECHNOLOGIES, MEDICAL TECHNOLOGY, MIGRANT WORKERS, MIGRATION, MULTIPLE INSURERS, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL HEALTH SERVICES, NUTRITION, OLDER PEOPLE, OUTPATIENT SERVICES, PATIENT, PATIENTS, PAYMENTS FOR HEALTH SERVICES, PENSION FUND, PHARMACEUTICAL POLICIES, PHARMACIES, PHYSICIAN, PHYSICIANS, POCKET PAYMENT, POCKET PAYMENTS, POLICY DOCUMENT, PRICE STRUCTURE, PRIMARY CARE, PRIVATE ENTERPRISES, PRIVATE HEALTH INSURANCE, PRIVATE HOSPITALS, PRIVATE INSURANCE, PROFITABILITY, PROGRAMS, PROVIDER PAYMENT, PUBLIC FUNDS, PUBLIC HEALTH, PUBLIC HOSPITAL, PUBLIC HOSPITAL SYSTEM, PURCHASING POWER, REIMBURSEMENT RATES, RISK OF DEFAULT, RURAL ACCESS, RURAL HEALTH CARE, SAFETY NETS, SAVINGS, SAVINGS ACCOUNT, SICKNESS FUNDS, SOCIAL HEALTH INSURANCE, SOCIAL INSURANCE, SOCIAL INSURANCE SYSTEM, SOCIAL SECURITY, SOCIAL WELFARE, SOURCES OF FUNDS, SUBSIDIZATION, UNEQUAL ACCESS, UNIONS, URBAN AREAS, URBAN HEALTH CARE, USE OF HEALTH SERVICES, VILLAGE, VILLAGES, WORKERS