Enigma of Health Statistics in China - MyAssignmenthelp.com

Question: Discuss about theEnigma of Health Statistics in China. Answer: Introduction Universal healthcare refers to a system of healthcare that provides financial protection and healthcare services to all citizens in a particular state or country. It has designed and organized in a manner that ensures all citizens in a society benefit from financial risk protection, equality and easy access to quality improved health care services (WHO, 2017). Since there is an assumption that every individual has access to the basic important healthcare, it might not be the case as some individuals lack of that access to equitable healthcare. The ridge between the rural and urban residents is a challenge that has continued in China over the years, along with the issues of significant health inequalities, increase of healthcare cost, poor quality of care delivery and weak public health functions. However, the government of China has made great efforts to address these challenges by rolling out policies to make essential improvements in their healthcare sector (Bhutta and Zulfiqar, 20 10). This essay takes the example of China to discuss the concept and overview of universal healthcare and the policy over the last 10 years. It also further discusses the principles and role played by the government to ensure effectiveness of health systems. Overview of Universal Healthcare in China for the last 10 years Health reforms in China began in the period when China was in great poverty around 30 years ago. Its previous healthcare system was adopted in the early 1980s due to its adoption of the strategies that solely depended on finances from the private sector to be used to fund the healthcare provision and the commercialization of these services. However, this had been developed after the country had dropped one of its most successful healthcare systems, which had greatly helped to improve the wellness of its people and marketability of the healthcare. Failures in the health market led to increased havoc and unfairness in the health sector. The aspect of making the health services private and make them commercial did lead to consequences that in future still had to be addressed. This is due to the fact that there was a creation of a ridge between the poor and the rich as the rich could get access to quality health services unlike the poor (Currie, Janet, Lin, and Zhang, 2011). The Government of China has been devoted to finding solutions facing the healthcare system by doing extensive research and investigations that are involving international scholars and organizations to help them to collect information on the negative implications of privatizing the healthcare sector. This has not only helped the government to know its consequences and causes but has been a revelation to the public too. It has also provided a foundation for reforms to be made in the Universal Health Care (UHC). Reforms on UHC were first announced in 2005 and they entailed targets of achieving a 100 percent change in the healthcare social coverage through three different insurances schemes that had been designed involving various populations groups, which were not enjoying sufficient healthcare provision. These insurance benefits are to greatly have an impact on a bigger population as forecasted by the year 2015 (Hebert et al, 2014). An effective UHC coverage in China seeks to ensure that every individual has medicinal drugs available to him or her. Therefore, it has made new investments that include disease prevention programs and primary healthcare provision services that are to ensure that services are provided to everyone. This comprises of the setting up of new buildings, the manufacturing of drugs that are essential and making them accessible to people through the distribution process, making the information systems electronic and also providing educational and training forums for physicians that are involved in primary healthcare provision. The healthcare system in China is undergoing tremendous changes and reforms (Lan, Xue and Liou, 2012.) Principles to Ensure Effectiveness of Health Systems Insurance Coverage Schemes Health insurance is one of the most essential components of universal coverage. In the late 1990s, China had established three major insurance programs. Then a new healthcare reform was started in 2009 aiming to provide universal health coverage to all its citizens, and to reduce disparities and improve healthcare services on those disadvantage population. The first insurance scheme began in the year 1998 in urban areas, known as Urban Employees Basic Medical Insurance (UEBMI) which provides employees with medical coverage in the public and private sector. It is a compulsory insurance scheme for all employment. Next, the New Rural Cooperative Medical Insurance (NRCM) was established in 2003 which targets at the rural regions. It covers part of the cost for all medical treatment but excluded certain outpatient and drug expenses. The premium of this insurance scheme is funded by both the governments and citizens. The third insurance scheme Urban Residents Basic Medical Insurance (URBMI ) was introduced in 2007 to provide coverage for urban residents in 79 cities who are not covered by UEBMI. The intention is to reduce impoverishment caused by chronic and fatal diseases. This insurance scheme was later expanded to nationwide in 2010 (He, Alex, Yang, and Hurst, 2015). The government of China adopted strategies to subsidize the premiums for the rural and urban people as a way of expanding its insurance coverage through the EMI. The western sides of the country are normally associated with a lower income hence the government decided to give them subsidies almost up to 90 percent on their premiums. The coastal regions that are characterized by people who are assumed financially stable were offered subsidies close to 70 percent of their premiums. The past few years have been characterized by an increase in premium as a way of improving the compensation rates. This can be seen through the government paying more premiums in 2008, under the URBMI and NCMS from 80 to 200 in 2011, showing a significant change. Besides this, the Ministry of Civil Affairs initiated a program called Medical Assistance, whereby it helps to pay premiums for the poor. There are also other reasons that have sped up the coverage of the insurance schemes and they include incentives such as the village leader or township mayor getting a promotion in accordance with the number of people under his or her leadership that have got insurance covers. This has led to the number of medical insurances covers increasing rapidly as the leaders strive to get these promotions. It is evident that the numbers have increased since in 2011 almost 95 percent of the people had EMI cover (China National Health Accounts Report, 2014). Prioritizing on Prevention The new health reforms in China prioritize on medicine that is used for preventive measures. The government has done this through provision of RMB25 yearly to every individual which is normally paid to the doctors that provide primary healthcare includes all the doctors in rural areas as well as doctors in the urban areas that provide healthcare services in regard to the number of people they serve. For instance, a doctor that is serving a population of 2000 people will receive RNB 50,000 in order to carry out provision to health services to all these individuals. The main duties of these doctors include provision of vaccines or immunization, prenatal and child care, visitation of outpatients, maintenance of records, provision of health education, monitoring of contagious diseases such as tuberculosis and monitoring patients with chronic conditions such as stroke or cardiac arrest. Besides China having these reforms, it lacks a way of monitoring the services provided by these doctors hence in case of a problem, it is hard to hold anyone accountable. Public Hospitals Reforms Normally, the public hospitals in China offer up to 90 percent of the whole countrys inpatients and outpatient facilities. The success of the healthcare reforms depends solely on the governments ability to improve the quality of the healthcare services to make the services efficient and accessible. The government can also attribute to the success of the reforms by controlling the health expenses as one way of protecting the patients from financials risks and this will attribute to increased patient satisfaction. The main challenge in the hospitals in China is their profit motivate hence they lack a well laid down mission to guide them. The central government also in its three-year health reforms never laid down concrete guidelines to help it achieve its motives. However, in the period 2009-2011, seventeen selected cities were used to experiment various approaches aimed at reforming public hospitals (Aitken and Valkova, 2013). Role Played by Government The most remarkable role played by the government is the insurance coverage, which has greatly helped in making healthcare services more affordable. This is evident from the insurance cover increments as from the year 2000 whereby it was 15 per cent to 95 per cent in 2011, comprising of 1.28 billion people being covered. This represents the success of universal healthcare reforms in China since a great number of people can get health insurance in a very short period thus showing that the health services are more accessible and affordable. This achievement has been attributed by the government whereby it decided to finance its citizens in healthcare provision due to its financial capability got from the rapid economic growth in China (Wang, 2011). The easier access to medical facilities or healthcare provision centers has been due to the 2009 health reforms. Through the various statistics carried out on health facilities national wide, it shows that physical access to these medical facilities greatly improved in 2008 and 2011. In the countrys central and western areas, the physical access to medical facilities increased by 83 percent in 2011. Improvement in access to healthcare services has been attributed to the health reforms. These reforms include the government subsidies in the insurance premiums, more improved medical programs, an increased number of investments in healthcare provision sector, insurance benefit packages, building up of more medical premises and provision of essential medical drugs. This has made UHC more affordable in China. UHC has been able to be achieved in China but the government has claimed that the benefits are averagely shallow and it is targeting to increase these benefits. For instance, the first benefit packages of URBMI and NCMS covered only the in-patients but the benefits were improved to cover also the outpatients. The specific benefits, however, vary in the fund allocation rates across the three major healthcare insurance schemes in China (Green, Jackisch, Zamaro, 2015). The government of Chinas reforms attempts in the public hospitals shows the immense pushback from public hospitals and the medical staff especially the physicians whose incomes from other activities that are profit-motivated will reduce. This has made China struggle in terms of solutions for the challenges facing its healthcare provision sector. The government may be willing to increase its amount of expenditure in the healthcare sector but this may not be directly proportional to the service output in the medical facilities. In order for changes to be experienced in terms of efficient service provision, there need to be changed in the health systems such as providing a monitoring system on the provision of the services, putting up of information systems, reforms on salaries/incentives and also alteration of the management team. Since China has made the health systems to be profit-motivated, it has made the health specialists to lose the professional ethics hence no transparency and accountability exercised in these medical facilities. This had led to unnecessary surgeries, tests, and drugs in most of the hospitals. The world can learn from China that medical ethics are necessary and once lost it are not easy to restore them back (Bi, et al, 2009). Effective provision of healthcare services requires reforms in the healthcare systems to as to ensure that there is the provision of quality healthcare services and drugs. These services should be equitable and accessible to the people in the rural areas who are financially incapable of buying expensive drugs. Good policies on human resource need also to be set up and implemented to curb exploitation from the private facilities that are profit-oriented. Finally, in this China case, we see that medical ethics are very important in the service provision sector. For instance, physicians have a duty professionally to diagnose and treat patients suffering from various diseases. In decision-making, the physicians need to put the interests of the patients first regardless of the current social or economic conditions. In China, the Hippocratic Oath was established as a way of ensuring that ethical standards are upheld and maintained (Bhutta and Zulfiqar, 2010). Conclusion The universal healthcare policy is a system of healthcare that provides healthcare services and financial protections to its citizens. The policy is designed in such a way that all the citizens benefit from the financial protection and easy access to healthcare services. In China, most people have an easy and equal access to affordable healthcare services; however, there is a slight disconnect in healthcare access between the rural and the urban residents, which poses a major challenge in equal access to healthcare. 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