Abstract

China's health-care reform is entering a crucial phase. Like many other countries, its disease burden is rapidly shifting, medical costs are soaring, and public expectations for health are increasing. In 2012, the estimated total cost of health-care services in China reached 2·89 trillion yuan (US$473·5 billion)—an 18·8% increase compared with the previous year. How has the Chinese Government responded to its mounting health service issues? One of the most vital moves is that in March, 2013, during its 10 yearly transition of national power, China officially announced a cabinet reshuffle plan for government efficiency. That reshuffle included merging the former Ministry of Health and the National Population and Family Planning Commission to establish the National Health and Family Planning Commission (NHFPC). Last week, the reorganisation scheme for the health authority was finally unveiled, which explicitly defined responsibilities, internal departments, and staffing size. What is especially worth mentioning is that a new department—the Department of Health System Reform—was created within the NHFPC. Previously China's health-care reform was independent of direct leadership from the former Ministry of Health, but was supervised by the Deepening the Health System Reform Leading Group of the State Council (China's chief administrative authority). Li Keqiang, the then Vice Premier, headed the group himself in 2008. Understandably, there are concerns whether or not the NHFPC can coordinate all the relevant stakeholders involved in health-care reform, which will require collective efforts that go far beyond the health sector. Additionally, the detailed management plan of the New Cooperative Medical Scheme for rural residents—one of the three social health insurance programmes for universal health coverage—remains up in the air. No matter what the health department structure will be, its fundamental role should focus on developing health policies and guidelines to protect and improve the population's health. Strengthening the organisation of the health sector is a welcome start, but what is really important next is to define and implement effective health policies, and deliver health-care reform in China.

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