A Comparison of the Health Systems in China and India
The world's two most populous countries, China and India, are undergoing dramatic demographic, societal, and economic transformations. However, the health status of residents of China and India still lags behind relative to other populations, and the health gains in each country have been uneven across subpopulations. Although they have achieved substantial advances in life expectancy and disease prevention since the middle of the 20th century, the Chinese and Indian health systems provide little protection against financial risk, and patient satisfaction is a lower priority than it should be. This paper compares the health systems of China and India to determine what approaches to improving health in these two countries do and do not work. In particular, the authors compare the health systems in China and India along three dimensions: policy levers, intermediate outcomes, and ultimate ends. The authors conclude that both countries must (1) restructure health care financing to reduce the burden of out-of-pocket medical care costs on individual patients; (2) increase access to care, especially in rural areas; (3) reduce dependence on fee-for-service contracts that promote overutilization of medical care; (4) build capacity for addressing and monitoring emerging diseases; and (5) match hospital capabilities with local needs.
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A Demographic Overview of the Two Countries
Financial Risk Protection
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barefoot doctors behaviors burden Caesarean sections central government China and India Chinese and Indian Chinese health Chinese Ministry clinics communicable diseases compared control of communicable costs Council of China Devadasan developing countries Development Research Center drugs economic efficiency Eggleston family planning fund Gupte health care financing health care services health care system health education health expenditures Health Indicators health insurance Health Policy Health Sector improve increased Indian health systems informal payments intermediate outcomes medical savings account Ministry of Health Mutatkar National Health National Health Services Organization out-of-pocket payments overuse overutilization patients percent PHCs policy levers poor population prevention primary health private health private insurance private practitioners private providers private sector programs Project Team Qadeer Ramachandran RAND reduce reform regulations residents Risk pooling rural areas social Spending on Health survey systems in China three-tiered total health ultimate ends urban World Bank