The Institutional Analysis On The Reform Of Health Care System In China

Since the 1980s, China started to reform the health care system. After 20 years , this reform has not been completed. There are still many problems in this reform, such as excessive growth of the medical fee that people are unable to bear the cost of medical, medical resources irrational allocation, lack of fairness, the monopoly of state-owned hospitals, the source of medical revenues unitary. From the perspective of institutional economics and economics of public, health care services is a public product, so the market can not effectively provides and the government should complete the most basic supplies, while including individuals, common enterprise and the third-party involvement, diversify supply systems, so the supply of medical services can increase. And under the pressure of market competition, supply quality can be improved and the price of services can be lower than before. This need clear division of market and government and the cooperation between them. China's current health care institutional change is a wide-range imperative change. The fundamental reason for changing the old system is the current system's operating costs too high and low income, while the return of new system is expected to yield higher than the cost of reform. Under the cost-benefit principle and the strong demand for the new system, reform is imperative. Under the guidance of the government, the health care system is promoted from top to bottom. That China's medical care system change has not been successful is due to market failures existing in the medical service market, and the government has not full played its role, and the financial expenditure is shortage, and the original pattern of interests is difficult to break. In a word, the reason is the market not available in the market and the lack of government. It can also be said that the current system design isn't rational. The role of the market and government isn't clearly defined their borders, and their roles are not in full play. We introduce Britain's, the United States', Singapore's and other countries' successful health care system models. From foreign experience, government should provide basic medical security. This is its own duties because of its public function, but in the process of specific systems design and implementation, government must act according to its ability, find other ways to develop investment and financing channels, innovate financing models, and encourage social capital to invest medical area. The experience of 20 years reform is summed up as follows: First, the border of government and market should be set according to specific condition; Secondly, The reform should adhere to the unity of fairness and efficiency, and the opportunity to people to enjoy basic medical services is fair taking into the result consideration. On this basis, we have made our health care institution design and policy recommendations: on the premise that the health care career as commonweal, make clear objectives of the reform as our guidance , open up the medical market, introduce market competition mechanism to break the monopoly ,let the market play a fundamental role in the allocation of medical resources. The functions of the government should be defined to provide basic medical services and form laws and regulations to improve the supervision of the operation of the market. What's more, the government also should bring in capital to encourage private hospitals and community hospitals, promote property rights change of state-owned hospitals to improve its operating efficiency, and introduce the "third party buying" mechanism. Finally, it should be to strengthen the building of professional ethics and the medical profession, enhance the communication between doctors and patients to improve the service quality and attitude of doctors. Policies should be promoted integrative to proceed to the reform smoothly.