Plenary Session II (b)

Health Care System in China and Recent Reform Initiatives

12:00 pm  -  12:20 pm



Since launching the health care reform in 2009, China has made significant progress in establishment of a basic health insurance system covering both urban and rural residents. China’s social health insurance schemes – including the Urban Employee Basic Medical Insurance scheme (UEBMI; launched in 1998), Urban Resident Basic Medical Insurance scheme (URBMI; launched in 2007), and the New Rural Cooperative Medical Scheme (NRCMS; launched in 2003) – have rapidly expanded during the past decade and now cover almost the whole Chinese population. The UEBMI scheme is mandatory for the employees and retirees in urban areas, with premiums paid by both employers and employees, covering outpatient expenditures, inpatient services and designated pharmacies. Those not covered by the UEBMI scheme could join the voluntary URBMI scheme jointly financed by enrollees and the government. Rural residents enroll voluntarily in the NRCMS scheme in the units of families, financed by the enrollees and the government. Payroll taxes are the main funding source for the UEBMI scheme, and government subsidies are the major funding sources for the URBMI scheme and NRCMS. In recent years, government health funding increased obviously and China’s total health expenditure as a percentage of GDP has attained 6% in 2015. Proportion of out-of-pocket payments in total health expenditures has been rapidly reduced after introduction of the social health insurance schemes. Due to the complexity and systematic nature, health care system reform in China is faced with many challenges that require persistence and development. The reform needs to go further in promoting comprehensive reform of health insurance, medical services delivery, and integrating basic health insurance schemes.

Dr ZHANG Hui (Vivienne)

Assistant Professor, Department of Health Policy and Management, Sun Yat-sen University