Hinsichtlich vieler dramatischer Szenen im Gesundheitssektor Chinas und nach intensiver Recherche über die Problematiken des chinesischen Gesundheitssystems wuchs das Interesse, mehr über die Problematiken der Gesundheitsversorgung in China zu erfahren, um hierfür Lösungsansätze zu erörtern. Nach der Einführung der Reform- und Öffnungspolitik von Deng Xiaoping wird auf der ganzen Welt von Chinas atemberaubendem Aufstieg berichtet. Der Wandel zum liberalisierten Handel führte zu einem verminderten Armutslevel und festigt China an die spitze der weltweiten Wirtschaftsmacht. Es ist nicht zu leugnen, dass sich China in einer Ära, von noch nie da gewesener Empfänglichkeit hinsichtlich ausländischer Einflüsse, befindet. Neben den Vorteilen die die neue Reform mit sich gebracht hat, sind innerhalb des ehemaligen zentralisierten Krankensystems schwere Probleme aufgetreten. Trotz dem intensiven Engagement der Regierung gibt es zahlreiche Bevölkerungsgruppen die im Gesundheitssystem benachteiligt werden. Nicht nur die Einführung der Wirtschaftsreform ist für die Chinesen ein Segen, sondern auch die Verbesserung der Gesundheitsreform hat viel zum höheren Lebensstandard beigetragen. Anderseits hat der Reformwechsel im Gesundheitssystem Nachteile mit sich gebracht. Durch die höhere Qualität der medizinischen Versorgung, ist auch der Zugang aufgrund Preiszuschläge schwerer als je zuvor. In dieser Thesis wird das Fehlverhalten vieler Bauern hinsichtlich der Gesundheit und Krankheit dargestellt, als auch die Funktion des zu überteuerten Gesundheitssystems, das im Schatten des Einheitsstaates von der Regierung geführt wird. Des Weiteren werden Lösungs- und Verbesserungsvorschläge vorgestellt, die zu einer Verbesserung des Gesundheitssystems in China führen können.
Table of Contents
1 Introduction
2 China’s healthcare organisation
2.1 The development phase of the healthcare system
2.2 China’s healthcare system
2.3 The health care financing system of China
2.4 The healthcare insurance of China
2.4.1 Basic medical insurance for urban workers
2.4.2 Basic medical insurance for urban residents
2.4.3 The rural cooperative medical care system
2.4.4 The survey of University students’ free medical care system
2.4.5 Survey of children’s medical insurance
2.4.6 Survey of medical services for foreigners
2.5 Refund of costs through the healthcare insurance
2.5.1 The doctor choice and hospital choice behaviour in China’s New Cooperative Medical System
2.5.2 Main medical expenses reimbursement problems of the New Rural Cooperative Medical System
2.5.3 Subsidies for severe disabilities
2.6 Reasons for non- participation of farmers in the medical care system
3 Reasons for the increasing poverty in the country-side
3.1 Back into poverty due to illness
3.2 The generally low cultural quality of the rural labour force
3.3 The rural economic and social environment
3.4 The relatively poor natural conditions in rural areas
4 Problems in the supply of drugs
4.1 Prevention of the circumvention of law
4.2 Some Regulations of the Drug Control Law
5 Relation between the doctor and patient
5.1 Medical corruption
6 Problems during the treatment
6.1 Bail as a delay of the treatment
6.2 Lack of Medical Knowledge of the farmers towards the pains
6.3 Problems with the diagnosis of illnesses
6.4 Hygiene problems
7 Health and illness
7.1 Understanding under “health and illness” of the World Health Organization
7.2 Understanding under “health and illness” of the farmers
7.3 Misbehaviour of farmers concerning health and illness
8 “Market failure” in the health services in the absence of the government intervention
8.1 Alternative models of government intervention
9 Suggestions for the problem of Chinas health care system
10 Conclusion
11 References
Research Objectives and Topics
This thesis examines the structural deficits and problems within the Chinese healthcare system, specifically focusing on the disparities between urban and rural access to medical services. It explores the financial burdens on farmers, the prevalence of medical corruption, and the negative consequences of hospital marketization, ultimately aiming to propose viable solutions for a more equitable healthcare structure.
- Analysis of China's healthcare organization and insurance systems across urban and rural regions.
- Investigation of the systemic reasons for poverty caused by healthcare-related financial strain.
- Evaluation of medical corruption (e.g., "Hongbao") and its impact on the doctor-patient relationship.
- Assessment of the challenges regarding the supply and quality of drugs, as well as hygiene in medical facilities.
- Discussion of potential strategies and policy improvements to mitigate current healthcare inequalities.
Excerpt from the Book
6.1 Bail as a delay of the treatment
Anyone has been involved in an emergency treatment has such an painful experience: patients are struggling against sickness in a hospital where doctors hustling by, and relatives are lining up for every single payment required before doctors retrieve their usual sympathetic attitude. What is worse, when you are short of money on you, or you miss out a single payment, then the patient is simply there in the hospital waiting to see God. Doctors are not sympathetic as you believed before you run into hospitals. While recently Health Ministry put forward a policy stating that patients can receive treatment before payments is made, which thrills all at the first glance. As for many emergency cases, golden time for treatment is always lost while people are lining up for the red tape, and that time is life is quite to the point in hospitals. On second thought, everyone comes to know the policy. There is an additional condition to this policy, which is deposit must be paid before treatment be given, otherwise still no treatment. Compared with the past treatment process, the policy only simplify the procedure without any other changes. While as it is a newly introduced policy and concerned with medical reform, apparently it draws public attention. People ask how effective is the policy, will safe, efficient, convent and low priced medical treatments be entailed, will the problem of “Hard and Expensive to see the doctor” be solved. All these are closely related with peoples’ interest, and they voice their own opinions that half surprise the author and half stay within my expectation.
Summary of Chapters
1 Introduction: Discusses the motivation for the work, highlighting the neglect of healthcare issues in China's development narrative and the need for structural improvement.
2 China’s healthcare organisation: Details the three-phase development of the healthcare system and the evolution of insurance schemes, noting the inherent disadvantages for rural residents.
3 Reasons for the increasing poverty in the country-side: Analyzes the socioeconomic and natural factors contributing to rural poverty, specifically emphasizing how illness causes families to regress into economic hardship.
4 Problems in the supply of drugs: Addresses the rampant issue of fake medicine and the lack of proper regulatory oversight in medical institutions.
5 Relation between the doctor and patient: Examines how low education and economic power affect the patient's agency, as well as the drivers behind medical corruption and the phenomenon of "Hongbao".
6 Problems during the treatment: Focuses on the "treatment-before-payment" policy debate and explores hygiene concerns within hospital operating rooms and infrastructure.
7 Health and illness: Explores the divergence between professional definitions of health (WHO) and traditional perceptions held by Chinese farmers, which influence their seeking of medical help.
8 “Market failure” in the health services in the absence of the government intervention: Analyzes the consequences of unchecked marketization in the medical sector and discusses alternative models for government intervention.
9 Suggestions for the problem of Chinas health care system: Proposes policy changes, including a network of government-owned clinics and enhanced regulation to correct market failures.
10 Conclusion: Summarizes the major findings and reiterates the urgency of addressing institutional deficits to ensure equitable health access.
Keywords
China, healthcare system, rural health, medical insurance, reimbursement problems, medical corruption, poverty, hospital marketization, doctor-patient relationship, public health policy, drug regulation, social security, socioeconomic development, rural-urban disparity, healthcare reform
Frequently Asked Questions
What is the core focus of this bachelor thesis?
The work focuses on identifying the systemic deficits and inequalities within the Chinese healthcare system, particularly the divide between urban and rural populations and the financial barriers to adequate medical care.
Which central topics are analyzed in the research?
The key themes include the evolution of healthcare insurance, the impact of hospital marketization, the causes of medical corruption, issues in drug supply, and the sociocultural aspects of health perceptions among farmers.
What is the primary objective of this study?
The objective is to provide a comprehensive analysis of the current state of China’s healthcare system and to suggest concrete policy improvements that could ensure better health outcomes for economically vulnerable groups.
What research methodology was employed?
The author utilized a mix of case studies, observations, and relevant literature, incorporating perspectives from diverse sources ranging from personal experiences in Chinese cities to official data and academic research.
Which aspects are covered in the main body of the work?
The main body covers the development and organization of insurance, the relationship between doctors and patients, the impact of hospital marketization on quality, and structural challenges like hygiene and the lack of medical knowledge among rural populations.
Which keywords best characterize this publication?
Key terms include China's healthcare system, rural health inequality, medical insurance, hospital marketization, medical corruption (Hongbao), and social security reform.
How does the "treatment-before-payment" policy affect patients?
The thesis argues that while the policy aims to save lives, it often remains a superficial change as patients are still required to pay significant deposits, which fails to protect those without immediate financial resources.
What role does the "Hongbao" phenomenon play in this context?
Hongbao serves as a specific indicator of medical corruption, where patients feel compelled to pay extra bribes to ensure quality medical service, highlighting the deeper psychological and institutional flaws in the current system.
- Arbeit zitieren
- Abdula Hamed (Autor:in), 2009, The problems of Chinas' health care system, München, GRIN Verlag, https://www.grin.com/document/186698
