Poverty Alleviation in China: Commitment, Policy and Expenditures

human development, poverty, empowerment

Bridging Fiscal Divergence in China

This dissertation asks, from the fiscal perspective, whether the Chinese government has been effective in moving towards a more equitable development strategy. It seeks to answer this question through an in-depth examination of China's intergovernmental fiscal system with respect to the following three aspects: public expenditure policies, fiscal inequality, and the intergovernmental fiscal transfer system. Chapter 1 aims to provide a comprehensive review of China's experience in fiscal decentralization. It examines the system of central control in the pre-reform period of 1949 to 1978; the fiscal contracting system, which resulted from a series of ad hoc decentralization reforms between 1979 and 1993; and the single most important intergovernmental fiscal reform, that of 1994. Following a thorough history and background knowledge of China's fiscal system in Chapter 1, Chapter 2 provides an institutional analysis of China's public expenditure policies by looking into the following three areas, expenditure assignment, expenditure composition and local accountability. This chapter tries to answer the question of whether China's public expenditure management serves the objective of adequate and equitable public services provision. Chapter 3 examines fiscal inequality at the provincial, prefectural, and county levels of government. Where data are available, the spending inequality on core public services is also explored. There is also a comparison of fiscal inequality at the provincial, prefectural, and county levels. With Chinese leaders and citizens expressing increasing concern at the regional inequalities that have accompanied China's rapid growth, the question of the redistributive effectiveness of the intergovernmental transfer system has become more and more important. The distribution of fiscal resources is taking the center stage in policy debates because the poorest regions may not be financially equipped to provide the most basic public services, such as education and health care, at the national average levels. The intergovernmental transfer system could ease fiscal disparities by equalizing fiscal capacity across regions. Chapter 4 conducts a comprehensive evaluation of the redistributive effects of the intergovernmental transfer system, at both the provincial and the county levels

The impact of the medical treatment combination model on stakeholders and patient flow in a Chinese county

Background and purpose Since China's reform and opening up, people’s demands for health service have increased, and requirements for healthcare service are higher with the rapid development of society and economy. Based on the reality of a county in China, the new operation and management model of medical reform the Medical Treatment Combination Model is established and implemented. This model integrates the medical resources in the county, reform the payment method of medical insurance, shift the management of medical institutions to profit seeking, and realize the united pursuit of medical institutions, doctors and patients, thus achieving the goal of safeguarding the health of the county's residents. Data source and research method Data source: this thesis used data from interviews to the stakeholders, statistics from health department and healthcare security department of Dancheng (DC) county, Henan province (HN) in China; annual reports, statistical reports, data from the Ministry of Health and other national authorities; documents from the State Council, the Ministry of Health, the Healthcare Security Administration and other relevant authorities of China. Research method: Through the content analysis of the interviews and statistic analysis of the data, the impact of the Medical Treatment Combination Model , or the new operation model featuring "the integration of county and township medical institutions into medical group operation (MHG) + integrated medical insurance package payment (IBPMI)", namely, th e MHG+IBPMI model (MHG+IBPMI) on the stakeholders and flow of patients in a county level region is observed, to provide reference for China's regional medical reform. Conclusion The establishment and implementation of the new operation and management mode in a county of China, namely the Medical Treatment Combination Mode (MHG+IBPMI), effectively shifts hospital's original operation direction of profit seeking, and realizes orderly patient flow so that medical resources and hierarchical medical treatment can be achieved. Thus, it improves the utilization rate of medical resources in township healthcare centers, while reducing hospital s medical expenditure, patients’ medical expenses and the risk of overspending medical insurance funds . Overall, it improves the accessibility of county medical services and promotes healthy development.Contexto Desde a reforma e abertura da China, a procura por serviços de saúde aumentou e os requisitos de serviços de saúde são maiores com o rápido desenvolvimento da sociedade e da economia. Com base na realidade de uma região da China, o novo modelo de gestão do sector da saúde o Modelo de Combinação de Tratamento Médico é definido e implementado. Este modelo integra os recursos médicos da regiã o, reforma o método de pagamento do seguro médico, muda o funcionamento das instituições médicas com fins lucrativos e integra instituições médicas, médicos e pacientes, alcançando assim o objetivo de salvaguardar a saúde dos residentes da região. Fonte dos dados e método de pesquisa Fonte dos dados: Esta tese usou dados obtidos de entrevistas feitas aos stakeholders, estatísticas do departamento de saúde e departamento de segurança de saúde da região de DC, província de Henan (HN) na China; dados de relatórios anuais, relatórios estatísticos, dados internos do Ministério da Saúde e outras autoridades nacionais; documentos do Conselho de Estado, do Ministério da Saúde, da Administração da Segurança da saúde, e de outras autoridades relevantes da China. Método de pesquisa: Através da análise do conteúdo das entrevistas, da análise estatística dos dados, o impacto do Modelo de Combinação de Tratamento Médico ou O Novo Modelo de Gestão que caracteriza "a integração de instituições médicas da região e municípios na gestão do grupo médico (MHG) + pagamento de pacote de seguro médico integrado (IBPMI)", ou seja, o modelo MHG + IBPMI (MHG + IBPMI) sobre as partes interessadas e o fluxo de pacientes na região é analisado, para sugerir políticas para a reforma mé dica regional da China. Conclusão A implementação do novo modo de gestão do sector da saúde numa região da China, ou seja, o Modo de Combinação de Tratamento Médico (MHG + IBPMI), altera a gestão hospitalar com objetivos de lucro e consegue um fluxo ordena do de pacientes, de modo a que os recursos médicos e o tratamento médico hierárquico sejam alcançados. A taxa de utilização de recursos médicos em centros de saúde municipais melhora e as despesas médicas do hospital reduzem. As despesas médicas dos pacienhospital reduzem. As despesas médicas dos pacientes e o risco de gastos excessivos com fundos de seguro médico também se reduzem. No geral, o novo modelo melhora a fundos de seguro médico também se reduzem. No geral, o novo modelo melhora a acessibilidade aos serviços médicos na região acessibilidade aos serviços médicos na região