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China’s health reform challenge

at 04:29 PM ET, 11/02/2011

A country, overwhelmed by rising health care costs, pours billions
of dollars into expanding health insurance coverage. This sounds a lot like what’s happening here in the United States, but it’s actually the story of another country’s health-reform efforts: China.

Over the past two years, China has pumped $27 billion into its health care system, increasing the rate of health insurance coverage to 94 percent of the population, with the goal of universal coverage by the end of this year. That’s a big shift from just three years ago, when as much as 90 percent of China’s rural population was uninsured.

The New York Times hosted a recent, online debate on the Chinese health reform efforts. What’s most striking about the debate is how familiar the issues feel to what we’re grappling with in the United States. A chief concern is whether the insurance that Chinese citizens have gained is robust enough to improve health. China, argues Harvard’s Yuanli Liu, “needs to provide not just ‘nominal coverage,’ but more ‘effective coverage’ by increasing the reimbursement rate and covering more cost-effective services for all Chinese.” Others bring up concerns about burdensome cost-sharing in Chinese health insurance as well as issues with doctors’ pay.

A lot of that sounds like the discussion that’s underway here in Washington right now. In determining what counts as “effective coverage,” the Obama administration is currently working on putting together a package of “essential health benefits” that, starting in 2014, all insurance plans will be required to cover.

Doctors’ pay will become an issue later this year as Congress will tackle another “doc fix:” an additional appropriation to keep Medicare doctor payments stable. Without that increased funding, doctors’ reimbursements would drop by about 27 percent in the coming year. Issues of co-pays have become increasingly problematic in the United States: a survey last month found employers expect their employees to pick up more of their insurance bill than ever before.

China and the United States are dealing with very different populations and demographics when it comes to health reform. But the end goals still look pretty similar: finding a balance between delivering high-quality medical care and also taming out-of-control health costs.

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