Armin Müller - Chinas New Public Health Insurance: Challenges to Health Reforms and the New Rural Co-operative Medical System

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Chinas New Public Health Insurance

Especially since the 2003 SARS crisis, Chinas healthcare system has become a growing source of concern, both for citizens and the Chinese government. Chinas once praised public health services have deteriorated into a system driven by economic constraints, in which poor people often fail to get access, and middle-income households risk to be dragged into poverty by the rising costs of care. The New Rural Co-operative Medical System (NRCMS) was introduced to counter these tendencies and constitutes the main system of public health insurance in China today. This book outlines the nature of the system, traces the processes of its enactment and implementation, and discusses its strengths and weaknesses. It argues that the contested nature of the fields of health policy and social security has long been overlooked, and reinterprets the NRCMS as a compromise between opposing political interests. Furthermore, it argues that structural institutional misfits facilitate fiscal imbalances and a culture of non-compliance in local health policy, which distort the outcomes of the implementation and limit the effectiveness of insurance. These dynamics also raise fundamental questions regarding the effectiveness of other areas of the comprehensive New Health Reform, which China has initiated to overhaul its healthcare system.

Armin Mller is a Postdoctoral Fellow at Georg-August-University in Gttingen, Germany.

China Policy Series

Series Editor: Zheng Yongnian, East Asian Institute, National University of Singapore

34. E-Government in China

Technology, power and local government reform

Jesper Schlger

35. Social Protest in Contemporary China, 2003-2010

Transitional pains and regime legitimacy

Yanqi Tong and Shaohua Lei

36. Chinas Evolving Industrial Policies and Economic Restructuring

Edited by Zheng Yongnian and Sarah Y. Tong

37. China Entering the Xi Jinping Era

Edited by Zheng Yongnian and Lance L. P. Gore

38. Chinas Assertive Nuclear Posture

State security in an anarchic international order

Baohui Zhang

39. Chinese Higher Education Reform and Social Justice

Edited by Bin Wu and W. John Morgan

40. International Engagement in Chinas Human Rights

Edited by Dingding Chen and Titus Chen

41. Chinas Transition from Communism - New Perspectives

Edited by Guoguang Wu and Helen Lansdowne

42. China-Taiwan Rapprochement

The political economy of cross-straits relations

Min-Hua Chiang

43. Ecological Risks and Disasters - New Experiences in China and Europe

Laurence Roulleau-Berger and Li Peilin

44. Chinas Governance Model

Flexibility and durability of pragmatic authoritarianism

Hongyi Lai

45. Chinas Great Urbanization

Edited by Yongnian Zheng, Litao Zhao, and Sarah Y. Tong

46. Chinas Global Quest for Resources

Energy, Food and Water

Edited by Fengshi Wu and Hongzhou Zhang

47. Chinas New Public Health Insurance

Challenges to Health Reforms and the New Rural Co-operative Medical System

Armin Mller

Chinas New Public Health Insurance

Challenges to Health Reforms and the New Rural Co-operative Medical System

Armin Mller

First published 2017

by Routledge

2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

and by Routledge

711 Third Avenue, New York, NY 10017

Routledge is an imprint of the Taylor & Francis Group, an informa business

2017 Armin Mller

The right of Armin Mller to be identified as author of this work has been asserted by him/her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

Names: Mller, Armin, 1981- author.

Title: Chinas new public health insurance : challenges to health reforms and the new rural co-operative medical system / Armin Mller.

Other titles: China policy series ; 47.

Description: Abingdon, Oxon ; New York, NY : Routledge, 2017. | Series: China policy series ; 47 | Includes bibliographical references and index.

Identifiers: LCCN 2016022167| ISBN 9781138639065 (hardback) | ISBN 9781315624792 (eBook)

Subjects: | MESH: National Health Programs | Health Care Reform | China

Classification: LCC HG9399.C62 | NLM WA 540 JC6 | DDC 368.4/ 200951-dc23

LC record available at https://lccn.loc.gov/2016022167

ISBN: 978-1-138-90272-5 (hbk)

ISBN: 978-1-315-69729-1 (ebk)

Figures

Tables

I am very grateful for the support of various people and organizations, which was indispensable for writing this book. First, I would like to thank the German Research Foundation (DFG), whose sponsorship of the research training group 1613 Risk and East Asia at the University of Duisburg-Essen provided me with the financial means and organizational framework to pursue my doctoral research. I remain deeply indebted to my supervisors Thomas Heberer and Gunter Schubert, whose support and guidance have accompanied me through most of my university career. My special gratitude goes to Yu Xianyang, WJY, Yan Shuangwu, YBR and ZH, who helped me organize my fieldwork in rural China, and to Karen Shire and Flemming Christiansen, whose advice and support has always been of considerable value. Furthermore, I would like to thank my interview partners, whom I have assured confidentiality, and the diligent students of Renmin University, Shandong University and Wuhan University, who accompanied me to the field and transcribed most of my interviews. Last but not least, I would like to thank Zheng Yongnian for considering this book for the China Policy Series, and the anonymous reviewer for the constructive and conscientious comments which helped to improve the manuscript.

Abbreviation	EnglishPinyin
ADB	Asian Development Bank
CHFP	Commission of Health and Family PlanningWeisheng Jihua Shengyu Weiyuanhui

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