Liang, LilinLangenbrunner, John C.2013-05-062013-05-062013-01https://hdl.handle.net/10986/13303The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to, and affordability of, health services. The Chinese government announced the national three-year reform plan in 2009, after which the country has made remarkable progress toward achieving nearly universal health coverage. The recent health reform initiatives under the 12th Five-Year Plan (2011-2015) continue to center on five areas. Building on recent experience, more effort is directed toward a structural change of the health system and building an environment that will facilitate policy implementation. This includes optimizing resource distribution, encouraging hospital competition, strengthening regulation and accountability, and enhancing human resources and information technology. While China has successfully extended the breadth of Health Coverage to the Poor (HCP), its scope (the comprehensiveness of services covered) and depth (the degree of financial risk protection) appear to be insufficient. Hospital admissions have increased significantly; suggesting improved access, up to 50 percent of current admissions may be amenable to more cost-effective outpatient care. Thus, it is critical to look into problems beyond the HCP program design, such as institutional arrangements, intergovernmental transfers, and supply constraints. This case study concludes with a discussion of the impacts of HCP and the needed next steps to advance HCP as an intermediate objective to the country's longer-term goals of equitable access and high quality of services.en-USCC BY 3.0 IGOAccess to health servicesaccess to servicesaccountability mechanismsadverse selectionadverse selection problemsallocative efficiencybasic health carebasic health servicesbedsbreast cancerbudget allocationcare institutionsCenter for Healthcervical cancercitiesclinicscommunity healthcommunity health servicescontribution ratecost controlcost structuredecision makingdelivery systemdeveloping countriesDevelopment Goalsdoctorseconomic growthelderlyelderly peopleepidemicequal accessequitable accessessential drugsessential medicinesExpendituresfamiliesfee schedulefee-for-servicefee-for-service systemfinancial barriersfinancial contributionsfinancial incentivesFinancial protectionfinancial riskfinancial risk protectionfinancial risksfiscal policiesfiscal policyGeneral Health Systemgeneral practitionersglobal budgetsglobal campaignhealth carehealth care costshealth care deliveryhealth care reformhealth care servicesHealth Care SystemHealth Care System Reformhealth care workershealth centersHealth Coveragehealth deliveryhealth delivery systemhealth educationHealth ExpenditureHealth Expenditureshealth financinghealth infrastructurehealth institutionshealth insurance coveragehealth insurance programhealth insurance schemeHealth Insurance Schemeshealth insurance systemhealth managementHealth Organizationhealth outcomeshealth planninghealth policyhealth professionalshealth programsHealth providershealth reformhealth reformshealth resourceshealth sectorHealth Servicehealth service utilizationHealth ServicesHealth StatusHealth Systemhealth system reformhealth systemshealth workershealth workforcehealthcare serviceshospital admissionHospital admissionshospital bedshospital carehospital costhospitalizationHospitalsHuman Resourcesill healthimpact evaluationsimpact on health outcomesincentives for doctorsincomeincome countriesinduced demandinformal sectorinformaticsinformation systeminformation systemsinpatient careinsurance coverageinsurance fundsinsurance premiumsinsurersintegrationinterventionkidney diseaseslarge citieslawsleukemialiving standardslocal authoritiesmarginal costsmarket economymedical billsmedical caremedical educationmedical expensesMedical Insurancemedical recordsmedical resourcesmedical savings accountsmedical servicesmedical staffmedicinesmental illnessmigrantmigrant workersMinistry of Healthmortalitymortality ratemovement of PeopleNational DevelopmentNational Healthnational health expenditureNational Health InsuranceNational Health Servicesnursesnursingoutpatient careoutpatient servicespatientpatient outcomesPatientspharmaceutical companiespharmacistsphysicianphysicianspocket paymentpolicy frameworkpolicy makerspolitical supportpoor healthprescription drugsprimary carePrivate Health Insuranceprogressprovider incentivesprovider paymentprovision of carepsychiatric hospitalPublic HealthPublic Health Servicespublic health spendingpublic hospitalPublic Hospitalspublic sectorpublic servicespublic spendingquality carequality of servicesreimbursement ratesRural Areasrural health carerural populationrural residentssafety netschool childrensocial developmentsocial equitysocial health insuranceSocial InsuranceSocial SecuritySocial Security benefitsSocial Servicessocial welfaretuberculosisunemploymentuniversal accessurban areasurbanizationvicious cycleviolencewasteworkersworking conditionsWorld Health OrganizationWorld Bank10.1596/13303