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Begin New Search Topic Governance Political Geography China Content Type Working Paper Publishing Institution Walter H. Shorenstein Asia-Pacific Research Center Publication Year within 25 Years

1. Healing One-fifth of Humanity: Progress and Challenges for China’s Health System

Author:
Karen Eggleston
Publication Date:
10-2019
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
China’s national health reforms over the past two decades have brought the system closer to the modern, safe, reliable and accessible health system that is commensurate with China’s dramatic economic growth, improvement in living standards, and high hopes for the next generation. Celebrating a decade this year, China’s national health reforms of 2009 consolidated a system of social health insurance covering the entire population for basic health services, contributing to a surge in healthcare utilization while reducing out-of-pocket costs to patients – which declined from 56% to 28% of total health expenditures between 2003 and 2017. An expanded basic public health service package, funded by per capita government budget allocations that include a higher central government subsidy for lower income provinces, provides basic population health services to all Chinese. A higher percentage of Chinese accessed hospital admissions in 2017 than in the average high-income (OECD) country – a large increase from the turn of the 21st century.i A recent re-shuffle of the governance structure consolidates the purchaser role for social health insurance schemes under the newly created National Healthcare Security Administration, with most other health sector functions under the re-christened National Health Commission, among other changes. China’s world-leading technological prowess in multiple fields spanning digital commerce to artificial intelligence—and accompanying innovative business models such as WeDoctor that have not yet been fully integrated into the health system—hold promise for supporting higher quality and more convenient healthcare for China’s 1.4 billion.
Topic:
Health, Science and Technology, Governance, and Health Care Policy
Political Geography:
China and Asia

2. Strategies and Public Propositions in Games of Institutional Change, Comparative Historical Cases

Author:
Masahiko Aoki
Publication Date:
06-2014
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
This paper argues that game-theoretic approach is incomplete for institutional studies, because comparative institutions as well as institutional changes involve a possibility of multiple equilibria. In order to solve the common knowledge problem, this paper proposes to unify game theoretic thought with an analysis of public representations/propositions to summarize salient features of the recursive/emergent states of play. From this perspective the paper tries to reconcile differences in three accounts of institutions, endogenous outcome, exogenous rules and constitutive rules accounts. Then, the unified approach is applied to comparative and historical cases of the Tokugawa Japan and the Qing China. Specifically it sheds new light into the coalitional nature of Tokugawa Baku-Han regime nesting the fundamental Samurai-village pact as well as the tendency toward decentralization of political violence and fiscal competence to the provincial level toward the end of the Qing China. From these new historical interpretations, endogenous strategic forces and associated public propositions leading to institutional changes through the Meiji Restoration and the Xinhai Revolution are identified and compared.
Topic:
Nationalism, Political Theory, and Governance
Political Geography:
China

3. Patient Copayments, Provider Incentives and Income Effects: Theory and Evidence from China's Essential Medications List Policy

Author:
Brian K. Chen
Publication Date:
09-2013
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
How do demand - and supply - side incentives interact, when there are potentially large provider income effects? We develop a simple model and empirically test it with data from China's Essential Medications List (EML) policy, which reduced patient copayments and changed provider incentives by removing a large source of revenue from primary care providers: drug dispensing revenues. Using a panel of patient - level spending and clinical data for Chinese patients with diabetes or hypertension over two and a half years, we find evidence of strategic provider response that dampened the impact of patient copayment reductions. Resource use and patient out - of - pocket spending did not change, when taking account of patient utilization outs ide primary care.
Topic:
Communism, Health, and Governance
Political Geography:
China and Israel