| Title |
Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives
|
|---|---|
| Published in |
Applied Health Economics and Health Policy, June 2016
|
| DOI | 10.1007/s40258-016-0254-1 |
| Pubmed ID | |
| Authors |
Alex Jingwei He, Shaolong Wu |
| 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, complicated by massive migration, has resulted in weak portability of SHI, creating further barriers to access. Third, many individuals are enrolled on multiple schemes, which causes inefficient use of government subsidies. Moral hazard and adverse selection are not effectively managed. The Chinese government announced its blueprint for integrating the urban and rural resident schemes in early 2016, paving the way for the ultimate consolidation of all SHI schemes and equal benefits for all. This article proposes three policy alternatives to inform the consolidation: (1) a single-pool system at the prefectural level with significant government subsidies, (2) a dual-pool system at the prefectural level with risk-equalization mechanisms, and (3) a household approach without merging existing pools. Vertical integration to the provincial level is unlikely to happen in the near future. Two caveats are raised to inform this transition towards universal health coverage. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 33% |
| New Zealand | 1 | 33% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
| Members of the public | 1 | 33% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 93 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 19 | 20% |
| Student > Ph. D. Student | 13 | 14% |
| Researcher | 8 | 9% |
| Student > Postgraduate | 5 | 5% |
| Student > Bachelor | 5 | 5% |
| Other | 18 | 19% |
| Unknown | 25 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Social Sciences | 16 | 17% |
| Medicine and Dentistry | 11 | 12% |
| Nursing and Health Professions | 11 | 12% |
| Economics, Econometrics and Finance | 10 | 11% |
| Business, Management and Accounting | 8 | 9% |
| Other | 9 | 10% |
| Unknown | 28 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 July 2016.
All research outputs
#16,722,190
of 25,374,917 outputs
Outputs from Applied Health Economics and Health Policy
#586
of 841 outputs
Outputs of similar age
#227,845
of 368,615 outputs
Outputs of similar age from Applied Health Economics and Health Policy
#16
of 19 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 841 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.3. This one is in the 27th percentile – i.e., 27% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 368,615 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.