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HEALTH SYSTEM AND FINANCING MECHANISM

HEALTH SYSTEM AND FINANCING MECHANISM. The National Cooperative Medical System (NCMS) in China Presented by Group 3: Sara, Ludvig , Caitlin, Gikandi , Laura and Aya. Presentation Agenda. Background Demography Economy Health statistics 2. The New Cooperative Medical Scheme (NCMS )

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HEALTH SYSTEM AND FINANCING MECHANISM

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  1. HEALTH SYSTEM AND FINANCING MECHANISM The National Cooperative Medical System (NCMS) in China Presented by Group 3: Sara, Ludvig, Caitlin, Gikandi, Laura and Aya

  2. Presentation Agenda • Background • Demography • Economy • Health statistics 2. The New Cooperative Medical Scheme (NCMS) • History • Organization • Levels of functioning • Payment mechanisms 3. Group Analysis • Pros and cons • Recommendations

  3. Background: Demography • Population: 1.384 billion, 7million people added annually • Population living in urban areas: 52% Source: http://www.who.int/gho/countries/chn.pdf?ua=1 (2012)

  4. Background: Economy • To be World’s largest economy by end of 2014 • GDP $9.240 trillion • Income level: Upper middle income • National wealth: 1/3 owned by 1% • Total expenditure on health as % of GDP (WHO, 2012): 5.4% Source: http://data.worldbank.org/country/china (2013)

  5. Background: Health statistics • Doctor : patient ratio • 2.8/1000 (Urban) • 0.95/1000 (Rural) • Life expectancy at birth m/f: 74/77 years (World Av 70) • Maternal mortality ratio /100000 live births: 32 (world Av 210)

  6. National Cooperative Medical Scheme:History • 1950’s – 1970’s : Cooperative Health Scheme • 1980’s: Major economic reforms • 2005: Introduction of the new NCMS • 2020: Target to achieve comprehensive universal health care Various sources

  7. Health Schemes in China • The new rural cooperative medical scheme (NCMS) • Urban employees basic medical insurance (URBMI) – Employees only • Urban residents basic medical insurance - Unemployed

  8. NCMS: Organization • 3 levels of functioning: central government, provinces and individual • Autonomy of provinces • Central contribution dependent on financial capacity of each province • Medical financial assistance program (vulnerable groups e.g elderly, impoverished, disabled) Source: Health Insurance in China: A brief note (Barber & Yao, 2010)

  9. The “Iron Triangle” of Healthcare

  10. China aimed to improve Access… • …but also wanted to avoid increased Costs • Dividing the costs between government, province and patient • That lead to some unfortunate implications • Disparity in expected service delivery (quality) and available resources – strains on the system • Provincial disparities – extra support to poorer provinces, not enough • Investments in urban health facilities – further disparities and workforce migration • Lack of accountability on official and provider level

  11. However, the system is not entirely bad! • Adapted to changing health needs e.g. prevention, chronic conditions, elderly care • Aims to redistribute finances and human resources • Aims to improve health care for all • Flexible system

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