China’s Healthcare System and Publicly Funded Medical Insurance
This report helps in understanding the social determinants of health based on communicable and non-communicable diseases. The country which is chosen for this report is China which is a country in East Asia and is considered one of the most populous countries across the globe with a population of 1.4 billion. Its economy is considered one of the fast-booming economies across the globe and it helps in attracting the exciting prospect of the businesses across the globe (World Bank, 2022). The country has the highest population across the globe which does make an impact on its healthcare system and affects the social determinants of health. 91% of the population of China is Han Chinese and 8% were minorities (MFA, 2022). Such a number does show that it has an impact on the health system of China which does make an impact on the health of the people of China.
The health care system within the country is associated with the facilities and services which is provided to the people of society and helps in understanding its effectiveness based on the quality and affordability. The health care system is important in managing the health issues within the country and developing the infrastructure that would help in overcoming the health issues present within the country. The healthcare system of China is based upon the provision of publicly funded medical insurance with the help of near-universal coverage (Commonwealth fund, 2022). Universal health coverage is based upon different public insurance programs which are mentioned below:
- Urban Employee Basic Medical Insurance which is mandatory for urban residents with jobs and was launched in 1998
- The voluntary Newly Cooperative medical scheme which was offered to rural residents in 2003
- The voluntary urban resident basic medical insurance was launched in 2007 to cover urban residents which do not have jobs as it includes children, older people etc.
Being one of the most populated countries across the globe, the health care system of China has been rated 144th in the world-by-World Health Organization (Aetna, 2022). The country spends 5.5% of its GDP on health measures and it has a lower number of doctors which is 1.6 per 1000 population. People do face language barriers while communicating with the staff and it does have the higher standards of a hospital in the Beijing and Shanghai but it does lack services in some parts of China.
Out-of-pocket expenditure – The out-of-pocket expenses are associated with the extra cost which is faced by the people of society to utilize the health services and the impact of such on the pocket of the people. The out-of-pocket expenditure in China as a share of the current health expenditure is slipped by 1.46% from 35.8% in 2018 to 35.2% in 2019 (Knoema, 2022). Such statistics do show that people have to face extra expenses to get effective medical services and make an impact on their pockets of the people. The people of China do face the burden of getting access to the services that make a direct impact on their health of people.
Inequalities – The inequalities in the health care system could be based upon the income and class of the people as it does make an impact on the health of the people in a long-term scenario. The 97% of the China elderly inequalities are not based upon the inter-provincial differences but it is based on factors such as age, gender, and culture (National Library of Medicine, 2019). It does make an impact on the health of people as they don’t have the access to such medical services and it does have a profound impact on the mentality of the people.
Out-of-Pocket Expenditure: Impact on Healthcare Accessibility in China
Privatization – China’s health care reform in 2009 has made a positive impact on its health system by expanding its insurance coverage but the country does face issues in managing its delivery system and cannot manage to achieve affordable access to health care for its people (National Library of Medicine, 2020). The privatisation of the profit-driven public hospital sector has resulted in boosting the health expenditure while patients face an increase in costs and does make an impact on the ability of people to pay for the services and resulting in poor health outcomes.
Cancer is considered one of the non-communicable diseases which is associated with the development of abnormal cells which divides uncontrollably and makes a negative impact on the health of the individual resulting in death. Cancer can be spread throughout the body and it is considered as second-leading cause of death across the globe. One of the leading causes of death in the globe is cancer. In addition to genetic predisposition, environmental pollutants and socioeconomic variables like lifestyle also contribute to the burden of cancer. As a result, the spread of this disease is not the same in every nation.Cancer is one of the diseases which is putting a burden on the China healthcare system. Based on the statistics of the GLOBOCAN 2018, about 4,285,300 new cancer cases were diagnosed in 2018 including the 2,366,010 males and 1,919,023 females (Chinese Medical Journal, 2022). It does show that men are the ones who are affected by cancer. The country is facing the heavy burden of lung and upper digestive tract cancers which does include the rising burden of prostate and breast cancers. The healthcare system does face a burden based on the number of cases and in the current scenario lung cancer is considered one of the most commonly diagnosed cancers in China. In the year 2022, there will be around 4,820,000 and 2,370,000 novel cancer cases, and 3,210,000 and 640,000 cancer deaths in China and America, correspondingly. The utmost mutual cancers are lung cancer in China and breast cancer in the America, and lung cancer is the foremost source of cancer death in both the cases (Xia et al. 2022). Globally, the burden of breast cancer is rising. With an increase in breast, gastric, and lung cancer cases, China is going through a cancer transition. Cancer has a high mortality rate in China. Urgently required are wide-ranging solutions to address China’s evolving cancer burden profiles. Cancer is still a key health issue in China while many efforts has been made for its prevention and control.
The social determinant for the health of the cancer is based upon the higher cost of treatment which incurs to cure such disease. The mortality rate due to such disease is very high which makes an impact on the health system of China and affects it in the long-term scenarios. Cancer is on the rise in China as the country has recorded 2.3 million deaths in 2014, from the disease and it does show that social determinants of health are affected by such disease. Cancer is growing in China which is putting a burden on its healthcare system and it requires innovative medicine and technique to overcome the threat of cancer. The government does focus on overcoming such threats by adopting a balanced approach and focused on adopting the health policy by implementing the Healthy China 2030 which aims towards improving the healthcare system and providing financial coverage to the needful people (WHO, 2022). The government is looking to make the reforms under such policy by taking preventive measures such as promoting a healthy lifestyle by organizing awareness campaigns and making an investment in the early diagnosis by performing regular check-ups. The country has its prevention plan which is based upon treating the needful and the duration of such plan is based on the term (2017-2025).
Inequalities in Healthcare: Dilemma faced by China’s Elderly Population
Human Immunodeficiency Virus (HIV) weaken the person’s immune system by destroying the important cell of the human body. At present, there is no cure for HIV as doctors are finding new approaches and research to overcome the problems (Lo, 2018). This, the virus destroys and impairs the functions of the immune system. However, the most advanced stage of HIV infection is more severe and requires timely treatment. The symptoms depend upon the different stages of infection and people living with HIV tend to be more infectious in the initial stage. There are around 1250000 people who are currently infected with HIV and 35000 deaths occur every year due to related health (Zhang et al., 2019). The number of diseases is currently increasing as government need to make effective implementation to overcome the problems. To overcome the problem, the government of China have maintained compulsory detention centre for the treatment. In 2020, 4.43 out of every 100,000 individuals in China will have been diagnosed with AIDS (acquired immune deficiency syndrome). Blood donations, prostitution, and intravenous drug use are generally to blame for the rise in AIDS incidence in China. Infection with the human immunodeficiency virus is what causes AIDS (HIV). Breast cancer is the utmost common cancer between women in China, asper the latest information from China’s national cancer registry.
China is at significant risk of generalising HIV as it is spreading through local relatively localise groups to the mainstream population. The Chinese government have identified 40560 cases of HIV by the end of 2021 and it has estimated about 1 million people are affected nationwide. The social determents of health encompass different factors like economic, financial and infrastructure to overcome the problems. It has been identified that China is handling HIV infection by reducing the treatment cost for the patients. In addition to this, the country has made remarkable achievements in HIV prevention and control during the past decade. The Joint Programme on HIV has estimated that the disease has been reduce by 0.1% in the year 2021 (Cao, Hsieh and Li, 2020).
The political and social commitment, as well as the international approach, is jointly responsible for the achievement of controlling the disease. The widespread HIV testing, timely diagnosis and linkage to cost-effective treatment is the major cause to prevent the disease. Apart from this, the government is focusing on a campaign regarding the spread of HIV and it is considered to be effective which helps in providing better support to reduce the number of patients. Improving access to care and enhancing the quality of care is another major contribution to reducing the disparities in eliminating the cases of HIV. Furthermore, it has been identified that social discrimination and lack of awareness are the major cause to prevent the disease.
SDH can be the game-changer as it incorporates behavioural as well as biomedical strategies which are important to reduce such cases. Now people are becoming more aware of the cause and taking preventive measures to overcome the issues. In China, HIV is still considered to be taboo as the government is trying to make society aware of HIV through public awareness scheme. Sex education is not taught in primary or middle school in China and cultural conservation tends to limit the discussion (Dong et al., 2018). The Chinese ministry is focusing on preventing such diseases by implementing new policies which help in preventing the diseases. The country is been successful to address the rising number of HIV cases by taking effective measures and precautions for society.
Privatization of Healthcare: Effects of China’s Health Care Reform
To reduce the HIV rising cases the government of China has implemented new policies like the Law of infectious disease prevention and control act 1989 where the patient has to report to the local authorities. This help in tracking the patient and helps in controlling the number of rising cases in the respective region. Besides this, to protect the right of women and young people as they are most affected by HIV the Chinese government have made law like protection of Mother and infant in the year 1995 as this state the premarital health examination which include testing for a specific disease. The authorities are taking an effective approach to control the HIV spread through commercial blood and plasma donation (Zhu et al., 2019). In addition to this, the government is trying to mobilize the department as well as sectors which help in providing better support and increase the desired results. At present, authorities are trying to implement a new education policy for the children as it allows them to make aware of HIV and its symptoms. Chinese government “Four Free and One Care” programme for AIDS control. Free antiretroviral drugs to AIDS patients who are rural peoples or individuals deprived of insurance living in town areas. Free unpaid counselling and testing. China government is also providing the free drugs to HIV-infected pregnant women to avoid mother-to-child spread, and HIV testing of new-born offspring. Moreover, government has also initiated a program under which free education for AIDS orphans and economic support to the families of individuals living with HIV/AIDS.
However, the Chinese government now recognise the seriousness of the HIV threat as this will have a direct impact on the country’s social and economic development. In the year 1998, the State Council Coordination Committee for HIV was established by Li Lanqing to identify the rising number of cases (Gao et al., 2019). Besides this, the law provides the blueprint for taking effective measures and making a better blueprint to prevent them from their friends and families from the disease. This law become effective as this highlighted the core point including condom promotion, drug maintenance therapy and last the social awareness for injecting the needles the drug users. There has been a firm determination of commitment by the key leaders of the Chinese government able to control the disease and provide better support to handle the situation more effectively.
The state council paid high attention to HIV prevention control as well as deployed effective strategies which help to eliminate risk. A responsible approach like a monitoring system, supervision and professional team helps in preventing such outcomes and overcoming the problems by taking effective measures and preventing overall outcomes. The government have started free voluntary council and HIV screening test as this allows to identify the cases and provide financial support to the respective patients (Li et al., 2018). Besides this, free drugs for HIV-infected pregnant women and testing for the newborn baby are taken by the government as this help prevent the number of cases. Along with this, there is free schooling for the children orphaned due to AIDS. All these laws are made to prevent the number of HIV cases and make individual health better.
Growing Cancer Burden in China
Conclusion
It is concluded that China needs to improve the infrastructure like the cost of treatment to prevent the rising number of cancer patients. To control the situation, the government is trying to build better infrastructure like access to the healthcare system and providing financial support to reduce the burden. The social determents related to cancer are the high cost as this impact the budget of the patient. To overcome the problems, the government is implementing new policies like financial support to make treatment available for most people. Besides this, HIV is another disease as it occurs due to a lack of awareness and rising drug cases are also a vital cause for the younger generation to have HIV. Free schooling, as well as treatment, is provided by the Chinese government to make a healthy society. It has been concluded that government have adopted numerous of the initiatives which are free of cost antiretroviral drugs to AIDS patients who are rural peoples or individuals deprived of insurance living in town areas. Free unpaid counselling and testing. China government is also providing the free drugs to HIV-infected pregnant women to avoid mother-to-child spread, and HIV testing of new-born offspring. Moreover, government has also initiated a program under which free education for AIDS orphans and economic support to the families of individuals living with HIV/AIDS.
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