Reforming China's Rural Health System

, by Wagstaff, Adam; Lindelow, Magnus; Wang, Shiyong; Zhang, Shuo

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ISBN: 9780821379820 | 0821379828
Cover: Paperback
Copyright: 6/16/2009

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This book assesses China's rural health system before and during the reforms of the 2000s, and outlines ideas for building on these reforms to further strengthen the system including over the long-term.

Foreword	p. xi
Acknowledgments	p. xv
Abbreviations	p. xix
Introduction	p. 1
China's Shift from Economic Growth to "Balanced Development"	p. 1
The World Bank's Analytic and Advisory Activities on China's Rural Health Sector	p. 5
Overview of the Book	p. 7
China's Health Challenges at the Start of the New Millennium	p. 13
Trends in Health Outcomes	p. 14
Trends in Health Inequalities	p. 18
Out-of-Pocket Costs-A Barrier to Care and a Cause of Poverty	p. 19
Accounting for the Household Burden	p. 22
Provider Incentives, Costs, and the Quality of Care	p. 25
Health Insurance Contraction	p. 28
Inequality in Government Spending	p. 29
Challenges and Reforms-Creating a Path Forward	p. 30
The Rural Health Reforms of the 2000s	p. 33
The New Rural Cooperative Medical Scheme	p. 34
Medical Assistance	p. 38
Public Health	p. 42
Provider Payment Reform	p. 49
Other Reforms in Service Delivery	p. 52
Sizing Up the Recent Reforms	p. 56
Annex: Impact Evaluation of NRCMS	p. 57
Looking Toward a New Decade: The Big Picture	p. 61
Health Systems-Goals, Functions, and Actors	p. 62
Evolving Ideas and International Best Practice	p. 64
Reform over the Medium Term	p. 72
Reform over the Longer Term	p. 78
Financing Rural Insurance Coverage	p. 81
More Resources for NRCMS	p. 82
Converting NRCMS into a "Purchaser"	p. 96
What Should Be Covered?	p. 98
Strengthening Management and Governance	p. 107
Priorities and Sequencing	p. 111
Improving Service Delivery: A Question of Incentives	p. 115
Changing Provider Incentives	p. 116
Enabling Providers to Respond to New Incentives	p. 133
Reform Priorities, Sequencing, and Capacity	p. 143
Enhancing Accountability and Incentives in Public Health	p. 147
The Misalignment of Incentives and Accountability	p. 151
Geographic Disparities in Spending	p. 153
Roles and Responsibilities across Levels of Government	p. 160
Clarifying Responsibilities and Financial Incentives at the County Level	p. 171
Priorities, Sequencing, Political Economy, and Skills	p. 182
Annex: Case Study of Public Health Financing and Organization in Two Counties	p. 185
The Longer-Term Reform Agenda	p. 187
Limitations of the Emerging Health Insurance Model	p. 187
A Dual Agenda for Financing Long-Term Reform	p. 192
Getting from Here to There	p. 198
Conclusions	p. 201
Notes	p. 205
References	p. 219
Index	p. 239
Boxes
NRCMS circa 2005	p. 36
Medical Assistance circa 2005	p. 39
Challenges in Estimating Public Health Spending and Comparing across Countries	p. 46
Provider Payment Reforms in Urban China	p. 50
Prospective Payments and Purchasing in NRCMS	p. 52
Impacts of Treatment Protocols, Drug Lists, and Other Innovations in the Health VIII Project in Gansu Province	p. 55
Trends in Financing Health in Rural China	p. 83
The Benefit Package in Mexico's Popular Health Insurance Program	p. 103
Medical Savings Accounts in China and Singapore	p. 105
Merging of NRCMS and BMI	p. 108
Health Insurance Governance in Estonia and Costa Rica	p. 109
Price Regulation in China	p. 116
International Experience with Provider Payment Reforms	p. 120
The Importance of Inpatient Care for NRCMS	p. 123
Setting Health Sector Prices in Japan	p. 129
Approaches to Extra Billing	p. 130
Table of Contents provided by Ingram. All Rights Reserved.

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Reforming China's Rural Health System

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