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Introduction to Health Sector Reform in China - Term Paper Example

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The author of this term paper "Introduction to Health Sector Reform in China" describes changing realities at the local level of governance in China, to be altering the foundations of financial access to the resources of healthcare. Healthcare inequality translates directly to financial inequality…
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Introduction to Health Sector Reform in China
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Download file to see previous pages With the end of the pure socialism of communal living and the financial erosion of the work-unit system in urban areas, it is more standard for individual inequalities to be the determining factor for healthcare access. (Duckett, 2007) Low-income individuals without health insurance may be able to cover a few minor medical incidents, but income inequities are likely to bring on financial insolvency, even when patients are able to pay. Where these financial inequities persist in a market with little viable insurance; the legitimate need for healthcare then becomes one more cause of poverty.
(Mackintosh 2001: 175). Though efforts are underway to re-establish a cooperative system of health financing.
By the late 1970s, the medical system in China was wedded to the over-arching government bureaucracy. Health services were just one more facet of the apparatus of administration and social control in a command economy.
A World Bank study has observed that by 1975 ‘almost all the urban population and 85 percent of the rural’ had a form of insurance that was at least able to provide the most basic of medical services, as well as cost-effective preventives, and sometimes curative treatments. This also entailed financial risks that to some extent, the population shared, in addition to the benefits in life expectancy. (World Bank 1997: 2), (World Bank 1992). In Rural regions, the 1960s and '70s saw many of these benefits in the form of vaccines and contraceptives; under the auspices of local control based upon the older system of rural communities funding the majority of their own health services. (Huang
1988; Kan 1990:42).
Under the older system, rural areas typically had a three-tiered system of regional organization was responsible for the administration of health services. There were hospitals at the county level, Health centers for communes that could provide referral services and the supervision of preventative treatments; and the communes. Individual village/communes had health stations staffed by rural practitioners sometimes known as ‘barefoot doctors’ (Bloom & Gu 1997).
These local-level commune health centers would report to the district commune-management communist party committee. The next step above them in medical matters was the county-level general hospital, for a higher level of technical support and supervision. But all of these institutions were under the auspices of a county health bureau, for the purpose of administration, rather than the actual treatment. The intent was to bring new dimensions of health-care to rural areas previously bereft of them in years before.
Attempts were made in the late '60s and '70s, what might be termed the late Mao era, to introduce an apparatus of collective funding, similar to health insurance programs to better assist the rural health-system for most villages. And for many rural residents, this at least improved physical access to health services. For jurisdictional purposes, the insurance-like policies were integrated into the bureaucracy of agricultural production and social services. (Liu et al. 1999: 1354). In rare cases, similar to the SARS phenomenon of 2003, doses of Central funding was injected into the rural system, for the purpose of widespread vaccination. Typically, under the older structure, the smaller, rural systems were funded by local commune welfare funds that often tapped household donations. ...Download file to see next pagesRead More
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