The Impact of China's Market Reforms on the Health of Chinese Citizens: Examining Two Puzzles

Martin King Whyte,Zhongxin Sun

doi:10.1142/s0219747210000038

Abstract

China's post-1978 market reforms were accompanied by a drastic decline in the coverage of the Chinese population by medical insurance as well as by sharp increases in charges for medical treatments, tests, and prescriptions. Since the 1990s, these trends have produced widespread condemnation of the current Chinese medical care system for being too costly and unequal. This article attempts to answer two questions: 1) Why did changes in the healthcare system precipitated by market reforms not lead to the kind of deterioration in the health of Chinese citizens that market reforms produced in Eastern Europe and the former Soviet Union? 2) In view of the increased inequalities in access to, and insurance coverage for, medical care since 1978, and particularly the growing rural-urban gap, why do Chinese villagers and migrants rate their current health better than do urban citizens?

Highlights

Since the 1990s these trends have produced widespread condemnation of the current Chinese medical care system as too costly and unequal, a critique embodied in an unprecedented Chinese government report in 2005 that declared the post-1978 reforms of the medical care system a failure
Even when household types are controlled for, other indicators of social status are significantly associated with medical insurance coverage, with the well-educated, those with high family incomes, Chinese Communist Party (CCP) members, and those with ties to state-owned enterprise (SOE) favored in this respect
One recent analysis portrays the Chinese health care system as in crisis, with potentially dire consequences: Gaps in health care are an important reason for growing anger in some rural districts toward the Chinese government, the Chinese Communist Party, and China’s new, wealthy elite and are contributing to increasingly frequent local riots and disturbances in rural China

Summary

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The Impact of China's Market Reforms on the Health of Chinese Citizens: Examining Two Puzzles. THE IMPACT OF CHINA’S MARKET REFORMS ON THE HEALTH OF CHINESE CITIZENS: EXAMINING TWO PUZZLES*

Martin King Whyte and Sun Zhongxin Abstract

Findings

Conclusions