2016
DOI: 10.1007/s40258-016-0254-1
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Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives

Abstract: China's remarkable progress in building a comprehensive social health insurance (SHI) system was swift and impressive. Yet the country's decentralized and incremental approach towards universal coverage has created a fragmented SHI system under which a series of structural deficiencies have emerged with negative impacts. First, contingent on local conditions and financing capacity, benefit packages vary considerably across schemes, leading to systematic inequity. Second, the existence of multiple schemes, comp… Show more

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Cited by 66 publications
(65 citation statements)
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“…The previous assessment of China's welfare transition under the Hu‐Wen leadership is further corroborated when considering the structural imbalance of welfare provision between rural and urban China. For instance, He and Wu () have argued that the path towards universal health insurance in China continues to be severely hampered by the existence of multiple social health insurance schemes and their limited portability across provincial lines. Focusing on the new rural co‐operative medical system for farmers, Li et al .…”
Section: Regional Fragmentation Of the Chinese Social Modelmentioning
confidence: 99%
“…The previous assessment of China's welfare transition under the Hu‐Wen leadership is further corroborated when considering the structural imbalance of welfare provision between rural and urban China. For instance, He and Wu () have argued that the path towards universal health insurance in China continues to be severely hampered by the existence of multiple social health insurance schemes and their limited portability across provincial lines. Focusing on the new rural co‐operative medical system for farmers, Li et al .…”
Section: Regional Fragmentation Of the Chinese Social Modelmentioning
confidence: 99%
“…2,57 Although these policies have greatly alleviated the financial burden caused by medical costs, there is still space for improvement. 58 This explains why outpatient satisfaction with medical costs was at a lower level.…”
Section: Discussionmentioning
confidence: 99%
“…Considering the economic conditions of countries, the results of the present study show that most of the interventions have performed in the eld of nancing or nancial protection functions. Thus, most interventions in these countries have focused on the insurance system and targeted the poor people or speci c groups of society [67,75,78,[80][81][82]120]. Also one of the issues that mostly reformed by countries is the payment and premium systems [60,65,99,121].…”
Section: Discussionmentioning
confidence: 99%