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Frontiers of Medicine

Front Med    2012, Vol. 6 Issue (1) : 79-84     DOI: 10.1007/s11684-012-0179-5
Integration of current identity-based district-varied health insurance schemes in China: implications and challenges
Hai-Qiang Wang, Zhi-Heng Liu, Yong-Zhao Zhang, Zhuo-Jing Luo()
Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
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With China’s great efforts to improve public health insurance, clear progress has been achieved toward the ambitious full health insurance coverage strategy for all. The current health insurance schemes in China fall into three categories: urban employee basic health insurance scheme, urban resident scheme, and new rural cooperative medical system. Despite their phasic success, these substantially identity-based, district-varied health insurance schemes have separate operation mechanisms, various administrative institutions, and consequently poor connections. On the other hand, the establishment and implementation of various health insurance schemes provide the preconditioning of more sophisticated social health insurance schemes, the increase in the income of urban and rural people, and the great importance attached by the government. Moreover, the reform of the “Hukou” (household register) system provides economical, official, and institutional bases. Therefore, the establishment of an urban-rural integrated, citizen-based, and nationwide-universal health insurance scheme by the government is critically important to attain equality and national connection. Accordingly, the differences between urban and rural areas should be minimized. In addition, the current schemes, administrative institutions, and networks should be integrated and interconnected. Moreover, more expenditure on health insurance might be essential for the integration despite the settings of global financial crisis. Regardless of the possible challenges in implementation, the proposed new scheme is promising and may be applied in the near future for the benefit of the Chinese people and global health.

Keywords health insurance      urban employee basic health insurance scheme      urban-resident scheme      new rural cooperative medical system     
Corresponding Authors: Luo Zhuo-Jing,   
Issue Date: 05 March 2012
 Cite this article:   
Hai-Qiang Wang,Zhi-Heng Liu,Yong-Zhao Zhang, et al. Integration of current identity-based district-varied health insurance schemes in China: implications and challenges[J]. Front Med, 2012, 6(1): 79-84.
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Hai-Qiang Wang
Zhi-Heng Liu
Yong-Zhao Zhang
Zhuo-Jing Luo
Fig.1  Derivation, making-up, and usage of pooled fund and individual medical savings accounts (MSAs) of the current health insurance schemes in China.
Fig.2  Flowchart of handling the proceedings of medical insurance for patients in hospitals, including outpatient and inpatient diagnoses and therapies.
Fig.3  Increasing enrollment of the basic health insurance scheme and the balance of the social pooled fund. Note that the balance in 2007 and 2008 includes the pooled fund of both basic health insurance and urban resident schemes. Data were according to Refs. 11 and 32.
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