Free Paper Sample on Transformation of China's Healthcare: A Critical Analysis of the 2009 Reform

Introduction

China became liberalized in 1978 and moved its economy to a socialistic market from central planning. Since then, China's healthcare system has undergone two major reform cycles (Tran Dai & Duchâtel, 2009). These reform cycles oscillated from reliance on the market for the funding and delivery of health care to the government being a central role player in financing health care, better prevention and primary care, and redistribution of resources to rural and poorer regions (Tran Dai & Duchâtel, 2009). As a result, there was an improvement in China's health system, with the country extending its health services to 1.3 billion people in the last ten years (Tran Dai & Duchâtel, 2009). Later on, China launched a new reform cycle, pushing vigorously for marketization and privatization as the major strategy in reforming its public hospitals (Tran Dai & Duchâtel, 2009). The reforms in the Chinese health system were undertaken in various phases. From the 1950s to 1978, the first phase was from 1978 to 2002, from 2002 to 2008, and finally from 2009 to 2012 (Tran Dai & Duchâtel, 2009).

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In this paper, the focus is on the Chinese health system reform of 2009. The paper looks at the formation and implementation process of the policy, its impact on the targeted policies, and its strengths and weaknesses. The Chinese health reform of 2009 was the last phase in a series of reforms that the Chinese government had put in place to reform the health sector. It was after the previous reforms had been implemented and the health sector still needed improvements that the 2009 health reform was initiated. In April 2009, the government of China launched its health care reforms, which were aimed at providing safe, affordable, and efficient basic health care for all the residents of China by 2020 (Tran Dai & Duchâtel, 2009). The reforms affirmed the role of the government in financing health care alongside priorities for prevention, primary care, and redistribution of human resources and finance to rural and poorer regions. The reforms were done with five major targets being set (Tran Dai & Duchâtel, 2009). The targets of the reforms included expanding the coverage for 95% of the population to be insured, making public health services equal and available for all residents of China, and improving the delivery system of primary care to enable the provision of universal basic health care (Tran Dai & Duchâtel, 2009). Also, the reforms targeted establishing an essential and basic system of medicine that will meet the needs of everyone in medicine. Finally, the launching of reforms in public hospitals in 17 cities to achieve better governance, management, and organization models to produce higher and more efficient hospital services was a target of the reform.

Stakeholders and Their Influence

The leading stakeholder in the health reforms in China is the Chinese government. This means that the government is the central and key player in the undertaking of the health reforms of 2009 (Oxford University Press, 2009). The government is the key stakeholder in the reforms since it is the one that is most heavily invested in the reform process (Oxford University Press, 2009). One of the ways that the government is invested in the reform system is in the provision of financial support to aid in the process of the reforms. The Chinese government first set aside $124 billion to be used in the reform process. Later on, an additional $230 billion was spent in aiding the reform process. The Ministry of Health was among the leading ministries through which the government took part in helping and shaping up the reforms (Oxford University Press, 2009). Later on, an additional $230 billion was spent in aiding the reform process. The Ministry of Health was among the leading ministries through which the government took part in helping and shaping up the reforms. The other way the government was a key stakeholder in the reforms was to ensure that policies were implemented (Oxford University Press, 2009). The government oversaw the formation and implementation of the necessary government policies through its various agencies.

The second major key player in the health care reforms in China is the World Bank. The World Bank had previously had a part to play in seven other projects in China (Yip & Hsiao, 2015). The role of the World Bank is to provide funding for the proposed projects. The health system reforms in China were the 8th major project that the World Bank was to help in China (Yip & Hsiao, 2015). The funding that was provided by the World Bank was to help in improving the provision of health services through purchasing medical equipment and drugs and even paying of the medical professionals and practitioners who were to aid in improving the health system (Yip & Hsiao, 2015). The money provided aided a lot in conducting research and surveys from which meaningful and useful information and data were collected. This data was later on to be used in the implementation of the health reforms.

Politics and politicians also played a major role in the reforms of the healthcare system in China. This is major because, without political goodwill, it would not have been possible to implement the reform policies (Yip & Hsiao, 2015). Politics plays a major role in implementing policies since most policies require the backing of the parliament through politicians for the policies to go. Therefore, the politicians also played a major role since they were responsible for passing the bills into policies through legislation.

Critical Evaluation of Factors That Led to Government’s Response

Situational Factors

The government of China was forced to react in response to the state of the health sector due to various situational factors. The first factor was the fact that only 46% of the population of China was under medical insurance coverage (Yip & Hsiao, 2015). This meant that a bigger percentage of the population was not insured medically. The second factor was the state of services that were provided by public hospitals (Yip & Hsiao, 2015). Most public hospitals in China offer low-quality services. Finally, the lack of adequate essential medicines was a cause for the government’s reactions

Structural Factors

The government’s reaction to the state of the health sector in China was due to several structural factors. The first factor was the policies that governed operations in the Chinese health department (Yip & Hsiao, 2015). There was a need for improvement and amendment of the policies that governed the sector. Secondly, there leadership structure for most hospitals was deemed unfit for the provision of better services(Yip & Hsiao, 2015). Hence, as a result, the Chinese government found it necessary to reform the health sector.

Cultural Factors

The main cultural factor that led to the government of China reforming the health sector was the belief by most Chinese residents that the services provided by public hospitals were of low quality (Yip & Hsiao, 2015). Hence, there were those who would seek alternative medication, which would not be quite as effective. Also, traditional medicines were a preferable source of medication for most of those who could not afford modern medication (Yip & Hsiao, 2015).

International Factors

International factors had a role to play in the reforms of the Chinese health sector of 2009. The first international factor was the reports by the World Health Organization that the overall health standards of the Chinese population were below proper health standards level (Yip & Hsiao, 2015). The other international factor was China’s low contribution to universal basic health care. The government wanted to improve the provision of basic healthcare in China so as to contribute to universal basic healthcare.

Prioritization of the Reforms

The 2009 healthcare system reform became a priority for the Chinese government due to various factors. These factors led to the reforms' prioritization after a series of evidence proved the necessity of the reforms. One of the main factors that led to the reforms' prioritization is that healthcare services were not easily accessible to people who resided in rural and poorer provinces of the country (Buse et al., 2012). People who fell ill or needed medical services in the poorer and rural regions were forced to cope with the illnesses in ineffective ways since they would not access better health care. Most of them succumbed to their illness over time since they could not get treated. The only option was to raise money enough to seek treatment in the urban and more developed regions of the country (Buse et al., 2012). Hence, the health reform system was to amend the situation and make sure that everyone could access better health care from wherever they lived in the country. Secondly, the health care reform system was to be used to increase the medical insurance coverage of China's residents (Buse et al., 2012). Only a small percentage of the people living in China were medically insured. Hence, there was a need to expand medical coverage insurance to ensure that most of China's population was insured medically.

Initially, only 46% of the population was insured, and this mostly consisted of the working class. Therefore, there was a need to enable the medical insurance of more people. Also, there was a lack of essential medicines in most hospitals (Buse et al., 2012). As a result, most patients who suffered from diseases and illnesses that would be cured by essential medicines would not be treated since those medicines were not available in the hospitals. Most patients would suffer from diseases and illnesses that could be cured by essential medicines, but the only way out would be getting the medications brought in from other regions (Buse et al., 2012). This would only be possible for the people with enough finances, which meant those who could not afford the cost were left to suffer. As a result, there was a need for reforms in the health system to ensure the availability of essential medicines that would be used for those in need. Finally, there was also an issue with the way major public hospitals were run. Most of the public hospitals lacked efficient organization, management, and governance (Buse et al., 2012). Therefore the hospitals would not be able to produce efficient and quality services for those who were in need. As a result, most patients would get misdiagnosed or ill-treated in their quest to look for medical services. A reform in the health system was necessary because it would ensure that public hospitals produce better services to patients.

Policy Formulation Process and Resultant Policy

Policy Type

The Chinese health system reform of 2009 falls under health policies. A health policy can be described as plans, decisions, and actions specifically put in place to achieve certain healthcare objectives within a specific community or society (Foundation, 2017). There are several categories under the health policies, with all of them dealing with various human health departments. The chines health reform of 2009 is an example of health policy (Foundation, 2017). This is because the reforms were put in place with strategic measures to ensure the improvement of the overall health standards of the residents of China.

Policy Instruments

Policy instruments can be defined as the interventions that a government or authority makes to achieve outcomes that are in line with the policy's objectives (Johnson et al., 2017). These interventions can be in various forms, from regulatory interventions to the provisions of services...