Health system reform in China: An assessment of recent trends

In this paper, we first briefly review the changes that the Chinese health care system has undergone since the early 1980s. We then describe the major current health policy initiatives in urban and rural areas and discuss likely scenarios for their evolution over time. Using comparisons with international experience regarding different institutional arrangements in the health care sector, we also discuss whether the approaches taken in China are likely to strengthen the health care system in terms of efficiency and equity. Our conclusion is that in order to predict how effectively China's future health care system will perform in the future, one must have more information about what role the state (central government) will play, as regulator, partial funder and direct provider in the system. We believe that the best strategy at present is to allow the development of a mixed model with significant roles for both the state and the private sector, in both the supply of health care services and the provision of health insurance