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Financial protection in health in rural China, 1978-2005: trends and current status.

This paper is a comprehensive review of journal articles as well as grey literature. PubMed, CINAHL, and EMBASE, published  March 2008  on Future healt public health sector reforms, China’s health care system is currently at a critical point, encountering unprecedented opportunities as well as challenges as a result of recent rapid economic development. The World Bank report identified acute serious illnesses to be the major risk factor for 30% of Chinese people who live below the official poverty line; other research studies have also indicated that chronic illnesses are major contributing factors for financial impoverishment in China. (World Bank, 1993; J. Chen, Lucas, & Gong, 2004) Unfortunately, the burden of health payment in China has been enormous and, according to the World Health Report 2000, China ranks 188 out of 191countries in ―fairness of financial contribution‖ in terms of health spending relative to income.In this paper, we focus on financial protection in rural China, where 745 million–57% of the Chinese people–reside (National Bureau of Statistics of China, 2006). First, we illustrate the degree of financial protection that rural residents have after a series of reforms and changes since 1978. Then we review the current rural health insurance reforms as well as the results from the pilot programs. We conclude with recommendations for future policies and programs. 

Health Systems, Health, Wealth and Societal Well-being Assessing the case for investing in health systems

“...Member States in the WHO European Region are facing a formidable economic crisis that is also calling into question the sustainability of the European social welfare model as a whole and necessitating even greater cost–effectiveness of health systems. Policy-makers are being called on to account for each and every area of public expenditure and are expected to maximize value for money; indeed, the sizeable share of public money that is devoted to health and the ever-increasing cost pressures and demands to cut public expenditure put health systems at the heart of the policy debate….”‘….The new policy argues for ‘whole-of-government’ and ‘whole-of-society’ approaches that will consolidate the ideals encompassed in health in all policies.This concept emphasizes the need to improve the integration of government activities with health and to reach out beyond government to engage patients and citizens, developing a responsive and inclusive approach to governance for health.The policy will be accompanied by a raft of evidence that underlines its rationale, most particularly around enabling implementation – a lynchpin for policy success. This includes a review of social determinants and the health divide in the European Region, pointing towards successful interventions, and studies on the economics of prevention and on effective tools to improve health governance……..” Content:1. Health systems, health, wealth and societal well-being: an introduction;2. Understanding health systems: scope, functions and objectives;3. Re-examining the cost pressures on health systems;4. Economic costs of ill health in the European Region;5. Saving lives? The contribution of health care to population health;6. The contribution of public health interventions: an economic perspective;7. Evidence for strategies to reduce socioeconomic inequalities in health in Europe;8. Being responsive to citizens’ expectations: the role of health services in responsiveness and satisfaction;9.  Assessing health reform trends in Europe;10. Performance measurement for health system improvement: experiences, challenges and   prospects;11. Investing in health systems: drawing the lessons    
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