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Effects of Rural Medical Financial Assistance in China
Abstract
This paper presents research results from the evaluation of the Medical Financial Assistance (MFA) program, supported by the World Bank, to extremely poor rural residents. It is found that MFA can help to improve the ability of the poor to make use of medical services, and especially their ability to receive services from township clinics. The present study also shows that adoption of the MFA mechanism helps to reduce the impact of disease on the economies of poor families, and prevents the poor afflicted with serious illnesses from being marginalized. However, as the beneficiaries often suffer from serious, complicated and lasting illnesses, the financial assistance is often insignificant in relation to medical expenses. Furthermore, the MFA plays no significant role in restoring a patient's income-earning ability. Copyright 2007 Institute of World Economics and Politics, Chinese Academy of Social Sciences.
... researchers have made full research on China's rural medical policies and effects.[15,16,17]. But there is still a lot of research gap on the health and health equity of poor rural residents in China under the background of targeted poverty alleviation. ...
Background: China’s targeted poverty alleviation policy is having a profound impact on the country’s rural economic and social development now. This study aimed to learn about the health status and health equity of rural poor residents under the implementation of the policy. It further explores the factors affecting the health status and health equity of rural poor residents, in order to contribute to the improvement of the policy.
Methods: Data from 1,233 rural poor residents were derived from a questionnaire survey from 12 prefecture-level cities and areas of Shaanxi province in 2017, and a self-evaluation of health was used to reflect the health status. A concentration index was applied to measure the inequity of the health status of rural poor residents. The decomposition method was employed to explore the source of health inequity.
Results: The results showed that 44.56% of rural poor residents in Shaanxi province had a poor or very poor health status, which was affected by their economic level, gender, age, the degree of education, and marital status. Additionally, participation in industry development, relocation, health poverty alleviation, and basic living standards were significantly correlated with the health status. The concentration index of the health status of rural poor residents in Shaanxi province was 0.0327. The primary contributors to the health inequity in different regions varied, but the economic level and the degree of education were the most significant factors, and the targeted poverty alleviation policy had a significant impact on the health equity.
Conclusions：The results indicated that the health status of rural poor residents in Shaanxi province was generally poor, there was a pro-rich inequity in the health status, and the degree of education and economic level were the primary factors affecting the health status and health equity. The targeted poverty alleviation policy greatly impacted the health status and health equity, and the difference in health status would lead to the inequity of benefits of the targeted poverty alleviation policy. In the future, the policy should focus on ensuring the sustainable development ability of rural residents with poor health status.
... However, because many of those covered by the scheme were vulnerable to serious, complicated health problems of long duration, the scheme did not offer adequate fi nancial protection. Many people continued to incur high medical expenditure for health conditions not covered by the MFA (77). In order to achieve its objective of social protection, the scheme would have to expand the range of services included in its benefi ts package and perhaps decrease the extent of co-payment. ...
Objective: China’s targeted poverty alleviation policy has a profound impact on the country’s rural economic and social development now. This study aimed to learn about the health status and health equity of rural poor residents under the implementation of the policy. It further explores the factors affecting the health status and health equity of rural poor residents in order to contribute to the improvement of the policy. Methods: The data of 1233 rural poor residents were collected from a questionnaire survey from 12 prefecture-level cities and areas of Shaanxi province in 2017, and the self-reported health was used to reflect the health status. A concentration index was applied to measure the inequity of the health status of rural poor residents. The decomposition method was employed to explore the source of health inequity. Results: The results showed that 44.56% of rural poor residents in Shaanxi province had a poor or very poor health status, which was affected by their economic level, gender, age, degree of education, and marital status. Additionally, participation in agricultural industry development, relocation, health poverty alleviation, and basic living standards were significantly correlated with health status. The concentration index of the health status of rural poor residents was 0.0327. The primary contributors to the health inequity in different regions varied, but the economic level and the degree of education were the most significant factors, and the targeted poverty alleviation policy had a significant impact on health equity. Conclusions: The results indicated that the health status of rural poor residents in Shaanxi province was generally poor, there was a pro-rich inequity in the health status, and the degree of education and economic level were the primary factors affecting the health status and health equity. The targeted poverty alleviation policy greatly impacted the health status and health equity of rural poor residents, and the difference in health status would lead to the inequity of benefits of the targeted poverty alleviation policy. In the future, the policy should focus on ensuring the sustainable development ability of rural residents with poor health status.
Objectives: Through a systematic review, to summarize and describe various health security mechanisms of protecting financial risk from illness in low and middle income countries (LMICs), and to analyze causes that lead to different effects in financial risk protecting. Methods: Search words were chosen by both health policy experts and search coordinators after discussion and pilot. Twenty-four electronic databases, websites of 11 health institutions, and the search engine Google were searched. Any original study to evaluate the role of financial protection of health security mechanism in LMICs was included. Pre-designed data extraction form was used for collecting strategies and study method of included studies, and extracted information was analyzed and described. Results: Fifty-two studies were included, and 56 specific health security mechanisms were categorized into 6: community-based health insurance, social health insurance, health sector reform, subsidy, user fee, and new rural cooperative medical scheme (NRCMS) in China. Forty-two mechanisms had positive effect in financial protection, 6 were negative, 5 had no effect and the effect of the other 2 was unclear. Conclusion: Mechanisms that produced positive effect can be summarized as: setting up of co-payment rate, design of benefit packages, providing free care for vulnerable population, delivering primary health care directly in remote area, and Chinese NRCMS. Mechanisms to protect the poor from financial risk of illness include: government provides health insurance, providing free care and setting up different co-payment rate according to income. The failure of health security mechanisms can be ascribed the deviation from its original goal of health security mechanism design, due to various inner or external causes.
La mondialisation n'aurait pas connu les formes ni le rythme qui sont les siennes si la Chine n’avait pas poursuivi la politique de réformes et d’ouverture entamée dès 1979. Et l’ascension chinoise ne se serait pas produite sans la mise en place des mécanismes technologiques, financiers, commerciaux et culturels de la mondialisation. En d’autres termes, les deux phénomènes ne peuvent être compris qu’en réciproque.
Cet essai propose de comprendre les défis politiques et culturels du système international contemporain à partir des inflexions que l’ascension chinoise leur apporte. Et il livre en même temps une lecture de la Chine d’aujourd’hui en fonction de ses modes d’ouverture aux mécanismes de la mondialisation. Il aborde en un tout systémique les dimensions politiques, culturelles, sociales et religieuses de l’extraordinaire transformation qui fait de la Chine l’acteur déterminant du monde contemporain. Il montre aussi combien la Chine poursuit une « quête de sens » déterminée par les questions qu’elle se pose sur son identité propre. Cette quête identitaire influence largement les formes que prend et que prendra la gouvernance mondiale.
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Impacts of Disease burden on households' income and consumption.” An evaluation report submitted to the Foreign Loan Office, Ministry of Health, on the MFA Program under the Health VIII Project of World Bank Loans
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A policy study report submitted to the Division of Rural Health, Ministry of Health
- Zhongyi Jiang
Jiang, Zhongyi, 2005, "The medical assistance system for the rural extremely poor." A policy study
report submitted to the Division of Rural Health, Ministry of Health, (unpublished documents).
An evaluation report submitted to the Foreign Loan Office, Ministry of Health, on the MFA program under the Health VIII Project of World Bank Loans
- Chengwu Jin
Jin, Chengwu, 2006, "Identifying Qualification of the MFA Beneficiaries." An evaluation report
submitted to the Foreign Loan Office, Ministry of Health, on the MFA program under the
Health VIII Project of World Bank Loans, Beijing.
An evaluation report submitted to the Foreign Loan Office, Ministry of Health, on the MFA Program under the Health VIII Project of World Bank Loans
- Chuliang Luo
Luo, Chuliang, 2006, "Impacts of Disease burden on households' income and consumption." An
evaluation report submitted to the Foreign Loan Office, Ministry of Health, on the MFA
Program under the Health VIII Project of World Bank Loans, Beijing.
An evaluation report submitted to the Foreign Loan Office, Ministry of Health, on the MFA Program under the Health VIII Project of World Bank Loans
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Wei, Zhong, 2006, "Effects of the MFA program on the use of medical services." An evaluation
report submitted to the Foreign Loan Office, Ministry of Health, on the MFA Program under
the Health VIII Project of World Bank Loans, Beijing.