Since 2009, China has been undergoing health care reform, the goal of which is the full coverage of 1.5 billion people with health insurance.
In the 20th century, only urban residents could count on medical services in China, and the bulk of the population (about 80%) did not have access to medical services at all. After the SARS epidemic in 2003, which exposed all the shortcomings of the medical care system and social insecurity of the population, the Chinese government decides to reform healthcare.
Officially, medical reform started in 2009 and provided for a gradual coverage of the entire population with medical insurance. Several insurance funds were formed, the filling principles of which are significantly different.
The insurance fund of the employed urban population is replenished by compulsory social contributions from the employer and employee from wages, which in total make up 8% (6% employer and 2% employee). Insurance coverage in this form is partial – almost 80-85% of the medical check, and has insurance limits.
The unoccupied urban population and the rural population make annual payments, however, a significant part of the insurance fund is financed by the state (at the central and local levels). Insurance coverage is slightly less – from 50% to 75%, depending on the type of medical facility. In this case, insurance covers almost everyone, including children and pensioners.
With the beginning of the implementation of the insurance system, its shortcomings immediately appeared for critical patients, the costs of which can significantly exceed the maximum coverage limits indicated above. Therefore, in 2015, additional insurance is introduced for critical illnesses associated with large medical costs.
The introduction of insurance medicine to a greater extent solved the issue of patients – more than 75% of the costs of medical care are covered by insurance funds as of 2018. More than 95% of the population of the largest country in the world use medical insurance. However, at the same time, the state faced the problem of a shortage of insurance funds. Moreover, this deficit is so great that hospitals in some regions simply limited patient care at the end of the calendar year, when the funds of insurance funds ran out. Therefore, while the Chinese government is working to resolve these problems.
For Ukraine, China’s experience is important and can provide useful lessons.
