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

2. NCDs : No. 1 Health Threat

3. 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).

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

5. Flaws: Healthcare System

6. 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).

7. 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

8. Solution: PPP for Constructing Big data and ICT Network

9. 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

10. Thanks!