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Member Research & Reports

Member Research & Reports

UAB Investigator Examines Lessons Learned from Urban Health Insurance Reform in China

“Health care systems often face competing goals and priorities, which make reforms challenging,” writes Dr. Haichang Xin, research associate in the department of health care organization and policy at the University of Alabama at Birmingham, in a recent study that investigated influences on the success of a health care system that is based on the urban health insurance reform evolution in China. “Findings based on health insurance reform strategies and mechanisms that did or did not work can effectively inform improvement of health insurance system design and practice, and overall health care system performance, including equity, efficiency, effectiveness, cost, finance, access, and coverage, both in China and other countries.”

[Photo: Dr. Haichang Xin]

Dr. Xin’s study is not only the first to assess the success and failure of China’s health care system by comparing data from before and after the economic reform that took place in the 1980s, but also is among the first to examine the factors influencing the efficacy of the country’s health care system by analyzing both technical and nontechnical causes, such as socioeconomics, culture, politics, values, and beliefs.

Based on study findings, Dr. Xin concludes that “a health insurance system is successful when it fits its social environment, economic framework, and cultural context, which translates to congruent health care policies, strategies, organization, and delivery. No health system can survive without its deeply rooted socioeconomic environment and cultural context. That is why one society should be cautious not to radically switch from a successful model to an entirely different one over time. There is no perfect health system model suitable for every population — only appropriate ones for specific nations and specific populations at the right place and right time.”

“Experiences and Lessons from Urban Health Insurance Reform in China” was published online in November in the journal Population Health Management.

Journal article: