A Comparison of the Health Systems in
Sai Ma, Neeraj Sood
Available online as PDF file [60p.] at: http://www.rand.org/pubs/occasional_papers/2008/RAND_OP212.pdf
“…..In this paper, the authors compare the health systems of China and India—the world’s two most populous countries, each of which is undergoing dramatic demographic, societal, and economic transformations—to determine what approaches to improving health in these two countries do and do not work. In particular, we compare the health systems of
- Policy levers are policies or behaviors that affect the financing, organization, and regulation of health care.
- Intermediate outcomes are the efficiency, quality, and level of access to care.
- The ultimate ends of a health care system are to promote better health, reduce the financial risks associated with medical care, and increase consumer satisfaction.
This paper identifies priority areas for reform in each country that can help improve the performance of each health system. Both countries must
- restructure health care financing to reduce the burden of out-of-pocket medical care costs on individual patients
- increase access to care, especially in rural areas
- reduce dependence on fee-for-service contracts that promote overutilization of medical care
- build capacity for addressing and monitoring emerging diseases
- match hospital capabilities with local needs.
CHAPTER ONE Analytical Framework
A Demographic Overview of the Two Countries
CHAPTER TWO A Brief History of the Health Systems in
Health System Evolution in
Health System Evolution in
CHAPTER THREE Overall Performance in Achieving Ultimate Ends
Key Health Indicators
Other Vital Health Indicators
Financial Risk Protection
CHAPTER FOUR Intermediate Outcomes: Access, Quality, and Efficiency
CHAPTER FIVE Policy Levers of Health Systems in
The Role of Insurance
Comparing Organization in
CHAPTER SIX Policy Implications
Key Challenges and Associated Policy Implications
Reduce the Out-of-Pocket Burden on Individual Consumers
Reduce Overutilization of Services
Increase Access to Care for the Poor
Build Capacity for Addressing and Monitoring Emerging Diseases (Such as HIV and Obesity)
Greater Private-Sector Involvement
Reduced Regulation of Drug and Procedure Prices
Increased Spending on Health, Especially Infrastructure, Providers, and Basic Necessities
Better Control of Communicable Diseases and Improvements in Maternal and Infant Health
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