Access to health care for all restrictions

 Access to health care for all restrictions
mm series of reviews of health care reform forty
Zhou Qi Ren
Economic Observer December 10, 2007 Monday
World Health Assembly in 1977 proposed a global goal of .30 years later, how to achieve this goal How, during which lessons China can draw on when planning for the future health care reform, which is the subject of this article. Goals into this series comments at the end to deal with, not that the subject is not important, but the authors believe that, left the constraints of the grasp of reality, the perfect moving target does not automatically equal to the actual problems.
when the WHO raised the goal social security scheme for the British post-war planning, planning for the transition period is 20 years. largely to the 1960s, the British did build a bear the financial burden, quality of service as well as being discontent, are the problems surfaced later. In the more developed the country, the British model, German model, plus the former Soviet Union model of the welfare and security together on the road. and then to one, from the the late 1970s before the advent of the new century, to promote the popularity of social welfare to all developing countries, According to the experience of developed countries to benefit. I see the background, said the WHO made this ambitious goal, had been inspired by a developing country experience. The developing countries of China, is the 1970 Rural China ; barefoot doctors mm so that the medical services network covers 500 million farmers, so excited about the reason the WHO is sufficient.
However, the A formal expression of the General Assembly goal, in fact, is WHO has issued a made a formal commitment to the global goal. perhaps because the WHO reference to the Chinese experience, so when he was appointed Minister of Health also proposed, .1980 era, access to health care of the people and the government can afford health care services. , China The cash, or do not mention 2010. The question is, will soon come in 2010, when can it be done?
I think the Government has failed to honor promises to be analyzed, can not be done because there is no to never speak of, as if it never existed in the world happened. This is because the established goals are not achieved, there are always some lessons worth remembering. to avoid embarrassing reality mm even put this reality mm point of the lessons learned, lack of health insurance limits the implementation of a clear understanding of the conditions.
to talk about targets white elephant. Originally, Chinese rural cooperative medical barefoot doctors and practices, the financial basis of a small group of farmers within a certain degree of self-financing and implementation of The Internet economy. all farmers and lived in the rural educated youth are aware, different parts of rural collectives, and even the same place in different small groups (production teams and brigades), between the collective welfare of all income levels and there is not a small difference. In the financial basis of the health care system to engage them, said was. In fact, even the .
such an experience, what really inspired the WHO, so that they think ; 2000 Health for All Who is responsible? the Chinese government is not United Nations agencies, you can write many wonderful vision and goals of moving the actual can not do it does not matter, anyway, continue to meet and continue to compile the file and continue to spend a lot of funds it wants the United Nations. The Chinese Government has to bear specific administrative responsibility, public commitment can not be cashed, untrustworthy, but also the things you kidding?
honestly said, large number of local social and economic development is highly unbalanced, but also because China is at an unprecedented process of transformation changes, the following three major long-term constraints, including constraints of the government commitment to health care.
first constraint condition is urbanization have long been suppressed, to accelerate the reform and opening up the outbreak of massive migration from rural to urban areas, into the city, will take a long time may form a new social structure. This is the barefoot doctor not the people's commune era things. Now do not mention anything else, the size of a single annual spring mm1 billion people on the train, hundreds of millions of people by bus mm seen the history of any country? this have a major impact on health care: the principle of territoriality of population protection system design, how to cope never large-scale population movements? health insurance for migrant workers in Guizhou, Sichuan, Anhui, work and life are in Beijing, Guangzhou, Shenzhen, out sick, is back home to see, or read the bill took back reimbursement? these problems, all German model, UK model are not met. those old country, is in early stages of urbanization, flow over a large majority of rural people into new social structure, with . health insurance, two constraints, namely financial situation. In recent years, China's fiscal revenue grew much faster than the GDP growth rate, can not help but aspire to the impossible. However, an increase of revenue regardless of how quickly, China's fiscal deficit or the government or the internal and external debt mm that is expenditure to grow faster, more places to spend money. to education for example, to. personal opinion, that promises to be technically difficult, because the government's budget is decided each year in March two, but the GDP going to know until the end. So what year faster GDP growth, which year but the proportion of government expenditure on education lower. education so that health care based on what may be one, the increase must be reduced to the premise of other projects. That is, do the addition to the condition to do subtraction. Now the trend is that every family to do addition, no less fixed, the result is that the Government in the national income The total share of the platter is increasing. This trend is not reversed, that . stresses the importance of great significance, and no one disagreed. health importance, education important, the environment important, important law and order, national defense more important mm this is no problem. The problem is, each . add less water surface, less surface water, the total tax burden and the government proceeds made increasingly large, non-funnel is not greater.
which brought out the last constraints, the public finance system oversight and governmental administrative efficiency. not that serious corruption, had not been seen since about the improvement. left to the use of public funds, who have been in previous years the report China's State Comptroller should have a profound impression. Anyway, I was not in the Beveridge Report of the United Kingdom mm known as the welfare state or any other similar public places to see coins mm abuse reports. As for the present government pomp, offices, buses and all public scale and level of overhead that do not look at system information, people have the opportunity to get some idea in their daily life.
This is very important. because all health care no matter which mode is called, always take the money to the government organizations focused on . If the administrative efficiency is poor, with high levels of corruption, nicely written and then the goal, in fact, have done some wrong way round. this point, we not only universal health insurance in China regrets that, but it should also feel lucky mm or whom as the ; molecular pocket? So, million can not think that the building of a security account is equivalent to achieve the and objectives of the model selection and time planning. the world moved in a wide variety of welfare programs is easy, but to other people's constraints are moved, not so easy. the world is not a country, the Government is not one. Chinese medical reform only Starting from their own constraints, it may hope to avoid re-cashed out.
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