Study On Health Care History In China And The U.S.

Health Care has been increasingly given special attention all over the world.With the social development and progress,governments become more and more concerned about the health care and take some actions to solve the problems which have emerged to improve the people's health.China and the U.S.began their own health care reforms in 2009 and in 2010 respectively,which is interesting if we have a look at the European countries,where health care benefits have been shrunk,while both Chinese health care reform and American health care reform intend to provide health insurance for every citizen in the country,which undoubtedly is adding health care welfare benefits.Is that coincidence or destiny? To answer the question the health care history in China and the U.S.should be analyzed.The dissertation is going to research the history of health care systems of China and the U.S.from 1912 to 2012.The main purpose of this study is to summarize the characteristics of the 100 years history of health care in China and the U.S.and compare the two countries' health care history,through which to find out the reason why they began to give more health care benefits to people while other countries give less.Furthermore,policy recommendations will be given based on the analysis of the result from the gap model.Based on the basic theories of public finance and social security theory,comparative research method,history and logics method will be used to do qualitative and quantitative analysis of health care history in China and the U.S.to find the government's role in health care legislation and health care practice,also to verify the essence of health care and the government's role in health care field.The dissertation consists of eight chapters.Chapter One is the introductory part,introducing the purpose of the study,its significance and the approaches for the study.Chapter Two is literature review.Chapter Three to Chapter Seven are the body part,analyzing the health care history from 1912 to 2012 in China and in the U.S.respectively.Chapter Eight is the conclusions and policy recommendations.It summarizes the findings and innovative achievements,makes policy recommendations and expresses expectations for future research.By analyzing the health care history in China and the U.S.from 1912 to 2012,and comparing the 100 years health care history in China and the U.S.In Chapter Eight five conclusions can be drawn as follows:1.The government finance is a necessary condition to provide good health care.The health care history in the Republic of China from 1912 to 1949 clearly proved that weak financial capacity led to poor enforcement of health care legislation,no money,no health care.In addition,the health care history in CCP revolutionary base areas from 1921 to 1949 also proved the same conclusion.2.The government finances and government responsibility are essential for providing good health care.A strong economic foundation and huge revenue can not bring good health care naturally,the key is to see whether the Government can put the pursuit of social justice and equality as a its responsibility and political objective.Government cost proportion of the total health care expenditure is a useful way to assess government's sense of responsibility.The Chinese government's burden ratio continued to decline,from more than 80% during the planned economy period to below 20% in 17 years after the reform and opening up.The U.S.health care history also illustrates the same point.Private market dominated health care field and led to high cost and low coverage.Through 100 year of trying the government at last gave a heavy blow to the market,the ACA promised to give all Americans universal health care coverage,which means to great extent the market has to be limited by government.3.The Chinese government and the U.S.government walking different routes to the same destination.In China the route is from government dominance to market dominance,and then back to government dominance,while in the U.S.the route is from market dominance to government dominance.Market can never be depended on in the health care field.4.Different routes and same destination also verified the quasi-public good essence of basic health care.The principle of China's new round of health care reform in 2009 is reinventing government in the area of health,especially in terms of the role of providing public goods,which marks the end of 30 years of market dominance of the area of health care.The ACA in the U.S.targets to provide health insurance for all Americans,which ended the 100 years of no universal coverage in the U.S.In addition,"basic" health care should be emphasized which as quasi-public good is supposed to be provided by the government,while high-level health care should be provided by the market.5.China has institutional advantage in health care reform.China emphasizes the concentration of power,while the U.S.emphasizes decentralized federalism.It is much easier for China to reform health care only if the government wants to,while the U.S.has extremely complicated opposition from the political parties,the Congress,and the interest groups,which was proved by the history of 100 years of trying to get universal health care coverage.By analyzing the gap between China and the U.S.fiscal balance,health care spending gap and the government health care expenditure gap,per capita health care cost gap as well as infant mortality and life expectancy gap,the following policy recommendations can be given to China's current health care reform:1.To fulfill the public function of the government.Chinese government is supposed to keep in mind that the basic health care is quasi-public good,and to increase government health expenditure and fulfill its own public function.2.To strengthen the influence of government health care expenditure on the demand of medical products.Government should design good health care system and increase health care expenditure in order to provide good health care services for all the people,and reduce the proportion of personal expenditure.3.To increase the government health expenditure increase on maternal and child health investment.Considered the changes in China's birth control policy,to further reduce infant and child mortality should be the focus of the future work,which is undoubtedly of great importance for China's future economic development.Although there are many reasons for infant mortality,but my analysis demonstrated increased government investment in health care will have a significant impact on reducing infant mortality.To unify maternity protection and medical insurance compulsively is a good way to protect maternal and child health.The two main innovations of this study are as follows:1.Research scope is expanded.The dissertation will have comprehensive and complete study on 100 years health care history of China and the U.S.2.Research content is expanded.The dissertation will give complete comparative analysis of the two countries' health care history.3.New research perspective is used.From the perspective of public finance to find the root causes of the contradiction between health care legislation and enforcement,the 100 years of health care history of China and the U.S.verified the theory that health care is quasi-public good.