Health policy reform in China

Abstract

The diversity of health systems around the world points to the path- dependency nature of health policies (Immergut, 1992; Tuohy, 1999). Given a complex array of political, economic, social, and institutional forces at work at any point in time, there are decisions which are made at critical juncture points (Acemoglu and Robinson, 2012) what shape the trajectory for health systems development. This chapter reviews the transformation of health policy in the People’s Republic of China that accompanied the major transforma- tion of China’s economy since the 1980s. From a low-cost system of basic health services that produced extraordinary health gains in the 1960s, the Chinese health system, particularly in rural areas, collapsed with the intro- duction of market reforms into the health system. During the 1990s, there were various reforms attempting to address the unanticipated consequences of these reforms but with limited effect (Lin et al., 2009). Since 2009, major system-wide reforms have been initiated, with universal health coverage as the aim.