Featuring The: Impulse Iq
Featuring The: Impulse Iq
Featuring The: Impulse Iq
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Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
Up until the 1950s, health care in China was of poor quality for
most Chinese and primarily paid by the patient with the more
affluent getting the better care. 50
!"#$% &
uring the !aoist era "1950s#19$0s%, China enacted
go&ernment health policies "the 'ural Cooperati&e !edical
(cheme ) 'C!(% intended to pro&ide
access to basic health care for e&en the poorest citi*ens.
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+his ga&e rise to the famous ,barefoot doctors- of the 19.0s
and 19$0s who had minimal training.
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/owe&er this did impro&e the general health of the
Chinese population ) the life e0pectancy went from 10
years at the end of the Communist 'e&olution to ..
years by 1920. GH +1I4JK 78L
M, 3 N O P 10 1920 .0
,3arefoot doctor-
Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
4ith the onset of eng 5iaoping6s mar7et based economic reforms of the
1920s, the financing and deli&ery of public health care shifted to local
go&ernments
who passed it on down to the patient.
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+he economic reforms &astly increased the incomes of most Chinese
and many were then able to purchase pri&ate health insurance and could afford
topay for more and better quality health care.
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3ut by 8001, .59 of health care e0penses were still paid by the patients. G
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Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
:n 8008 the go&ernment attempted to broaden insurance co&erage
to more of the population and created the ;ational Cooperati&e !edical
(cheme ";C!(%.8008 , +,Qjkl m/0 , n e opq
+his had the effect of reducing pri&ate spending to 1.9 "still a much higher
percentage than in many other countries% due to direct subsidies
paid to go&ernment doctors, clinics, and hospitals for citi*ens who bought the
go&ernment#sponsored insurance. +1 E rs 1.9, G
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3ut health care deli&ery in the rural areas was still inadequate and<or
unaffordable, so in 800$ the go&ernment introduced the Urban
'esidents6 3asic !edical :nsurance program "U'3!%. G .\ @
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ue to the ;C!( and U'3! systems, since 8009 959 of the Chinese
population has some sort of health care co&erage. +he current slogan is
,equal access by 8018 and uni&ersal co&erage by 8080.- T +1,
8009 959 cK e . +,3 H =,8018
S=b8080 sqop
>nrollment in these programs is still &oluntary but strongly encouraged by
the go&ernment. 9 -tuHGH+,
Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
/owe&er the large enrollment in these health care plans encouraged the
use of e0pensi&e, higher#le&el pro&iders.
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/ealth care deli&ery is primarily hospital#based managed through the
!inistry of /ealth and this is not cost#efficient.
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?ttempts to reform the system and reduce costs has placed emphasis
on a shift of care toward non#hospital based primary care to local primary
care pro&iders with the goal of 8 or @ general practitioners for e&ery 10,000
residents.
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+his is being met with resistance since patients ha&e a distrust of the quality
of primary care pro&iders "appro0imately 509 of health care pro&iders6
incomes comes from the sale of high#profit margin drug ) thus Chinese doctors
&astly o&er#prescribe medications%. +1 7 45
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Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
+he current goals of the Chinese medical system are=
/0
1. to achie&e uni&ersal health care co&erage, ; Leop
8. strengthen primary care, 78
@. raise clinical quality, and 4J
1. impro&e incenti&es for health care pro&iders to reduce demand on more
e0pensi&e hospital#base care. 4J - , rh 7
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&hat is it and ho' does it 'or(
&hat is it and ho' does it 'or(
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