A Study of Healthcare Reform in China in Light of the USA and Canadian Systems

Greg Chen


This article describes and examines the newly implemented basic medical insurance system for urban employees in China. The insurance system was built on two distinct concepts, individual providence and social insurance, and was characterized by national government mandates, local government administration, and employer/employee contributions. The study found that the Chinese basic medical insurance program for urban employees was implemented in all major urban areas. About 130 million people were covered under the scheme as of May 2005. The program benefits are limited with relatively low ceilings on reimbursable expenses and high cost sharing from the insured. The procedure for reimbursement is complicated and time consuming. China can learn from the U.S. and Canadian systems in both financing and providing healthcare. The U.S. system arguably supplies the best medical services in terms of quality and accessibility for those who are insured and those who can pay out of pocket. But the huge costs may not work well with China at present. The Canadian system, which is relatively effective, efficient, and equitable, although not as accessible, may fit China better. The study also suggests that the U.S. employer-based healthcare insurance system requires a major overhaul. It puts U.S. companies at a disadvantaged position in the increasingly competitive global marketplace.

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DOI: http://dx.doi.org/10.22140/cpar.v10i2.203


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Chinese Public Administration Review (ISSN 1539-6754, Online ISSN 2573-1483)  is published by the School of Government, Sun Yat-sen University.