A Comparison of the Health Systems in China and IndiaIn this paper, we compare the health systems of China and India the world's two most populous countries, each of which is undergoing dramatic demographic, societal, and economic transformations to determine what approaches to improving health in these two countries do and do not work. In particular, we compare the health systems of China and India along three dimensions: policy levers, intermediate outcomes, and ultimate ends. Policy levers are policies or behaviors that affect the financing, organization, and regulation of health care. Intermediate outcomes are the efficiency, quality, and level of access to care. The ultimate ends of a health care system are to promote better health, reduce the financial risks associated with medical care, and increase consumer satisfaction. We conclude that both China and India have achieved substantial gains in life expectancy and disease prevention since independence; these gains are more substantial in China. However, both countries health systems provide little protection against financial risk, and patient satisfaction is a lower priority than it should be. This paper identifies priority areas for reform in each country that can help improve the performance of each health system. Both countries must * restructure health care financing to reduce the burden of out-of-pocket medical care costs on individual patients * increase access to care, especially in rural areas * reduce dependence on fee-for-service contracts that promote overutilization of medical care * build capacity for addressing and monitoring emerging diseases * match hospital capabilities with local needs. |
Contents
Health System Evolution in India | 8 |
Efficiency | 21 |
Payment | 27 |
Copyright | |
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barefoot doctors behaviors Beijing burden Caesarean sections central government challenges 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 investments 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 providers private sector programs Project Team Qadeer Ramachandran RAND reduce reform regulations rural areas social Spending on Health survey systems in China three-tiered U.S. Dollars ultimate ends urban World Bank