Research On The Fairness And Efficiency Of My Country's Health Security System

This research was done under such context:the health services utilization for the urban and rural residents decreased and the doctor-patient relationship deteriorated due to the equity of financial contribution decline and health service accessibility imbalances. A study pointed out that the health system reform lost both efficiency and equity. A relatively comprehensive and systematic review about the efficiency and equity of health protection system had been done since the establishment of the People’s Republic of China.The authors used the methods such as Gini coefficient, concentration coefficient, Kakwani index and direct comparison, et al. to measure the equity of health services provision, health care utilization, financial contribution and health status between the original and the existing health security system, and between the provincial, urban and rural sites; Time series DEA method was used to evaluate the technical efficiency of the original and the existing health security system. The result showed that before Reform and Opening, the equity of the health security system continuously improved; but after Reform and Opening, especially after the social medical insurance reform in 1998, there was a downward trend in both fairness and technical efficiency in health security system. And it was not until the government established a large-scale new cooperative medical scheme for rural residents and medical insurance payment system for urban residents that the equity and technical efficiency in health security system was significantly improved.Then the conditions and the pathway to achieve equity and efficiency equilibrium of the health protection system was theoretically analyzed, and the problems of information dissymmetry and heath protection financing which had a great impact on the equity and efficiency of health protection system were selectively analyzed.Finally, according to the actual situation in our country, a three-step was proposed to achieve the reform objectives of the health protection system for the whole nation with the view of "universal coverage, multi-levels, family mutual aid, supply and demand coordination and efficient operation ".