NCDs and Healthcare System in China Qiao Yu School of Public policy & Management Tsinghua University Dec. 10, 2015

NCDs : No. 1 Health Threat

2012 survey for adults above 18 years old: high blood pressure 25.2% Among 10.3 million annual death, NCDs (heart disease, diabetes, cancer, and chronic respiratory diseases) accounted for 80% (World Bank, 2011) 2012 survey for adults above 18 years old: high blood pressure 25.2% diabetes 9.7% chronic respiratory diseases 9.9% (Ministry of Health, 2015).  

In 2000-2015, heart disease, diabetes and stroke may cause losses of $550 billion (WHO, 2005).   In 2010, expenses on NCDs were 1291.8 billion yuan, 69.98% of total healthcare expenditure, 3.22% of GDP (He, 2014). Government: 129.9 blllion yuan, 10.06% Social security: 550.6 billion yuan,42.65% Family: 610.6 billion yuan, 47.29%.  

Flaws: Healthcare System

Multi-layered framework: 3 basic healthcare nets for general public: urban employees urban residents without jobs rural residents; 2 special care nets: old revolutionary veterans senior officials Local-managed basic healthcare nets: city governments (652 cities) county governments (over 1300).

Big differences between nets and regions regarding pricing and co-payment : Shanghai: urban employee reimburse 85% up to 340,000 yuan; urban resident 50%; Qinghai: urban employee reimburse 40% and up to 20,000 yuan Severe informative asymmetry: Data are in hospitals, local Social Security Bureaus have no enough info and expertise, ending up huge moral hazard, inefficient allocation of resources, little commercial insurance

Solution: PPP for Constructing Big data and ICT Network

Local authorities: set up healthcare information center to centralize and integrate data Create useful tools: drawing pricing and copayment standards monitoring abnormal and outliers; improving hospital management; assisting diagnosis, etc. Attract commercial insurance firms to participate market to deepen coverage

Thanks!