Transformation of Health Insurance Schemes in China: Lessons for Access

Health insurance has been one of the major forms of health financing in China since the 1950s. Health insurance in China has seen dramatic shifts given the different economic and political contexts. From an almost universal coverage and access to health services in the pre-reforms period, China witnessed tremendous inequities in access with the breakdown of its collective financing structures and rising costs of health care in the 1980s and 1990s in both rural and urban areas with the onset of economic reforms. As a result policies in the late 1990s and 2000s shifted towards universalising access by introducing different insurance schemes for the urban and rural population. This article attempts to trace this transformation in insurance schemes through three distinct phases and draws lessons for access to health services.