Managed care systems in the people's republic of china

Abstract

This article attempts to determine whether or not managed care is the way forward for health services systems reforms in urban China. It first highlights the problems of the present Chinese urban health care financing system, which is largely based on third party fee-for-service reimbursement. It then analyses the salient features of three existing managed care systems in China -private plans, plans under the existing public and labor medical insurance systems, and the newly introduced pilot Employees Medical Insurance Scheme. Available evidence tend to suggest that all of them have been quite effective in controlling cost escalation, and that there have been some improvement in terms of equity under the new Employees Medical Insurance Scheme.