Urban Health Insurance System Reform Policy Tool

Health is the most fundamental element for our human race to live and develop; health care system is one of the fundamental social systems our society must build up. Health care has its particularity,due to influences from information asymmetry, adverse selection,moral hazard and so on.To establish a health care system with both equity and efficiency is a hot research topic all around the world,and a global conundrum as well.China has experienced four phases of urban health care reform since its opening-up in 1978.These four phases are free health care and labor insurance health care reform(1978-1992),establishing basic health insurance system for urban employees(1993-1998),developing multi-level health insurance system (1999-2005),and neo-health care reform(2006-2009).Up to now,to solve the problem of difficult access and high cost of health care,and ensure that each citizen is covered by the basic health care system is the most urgent task for the government.Policy instrument tightly connects policy objectives and policy implementation. A favorable policy objective always needs appropriate policy instruments to achieve. Appropriate choosing of policy instruments may increase the pertinence of policy implementation to specific policy objects,reduce the difficulty of policy implementation,efficiently act on the policy problem and achieve the aim.Influenced by policy problem cognizance,policy environment,correlative groups and so on, China's urban health care reform has shown differences on the policy objectives,the application of policy instruments and the reform outcomes among the four phases.In the theory aspect,this article uses the policy instrument theory to separately discuss and analyze the four phases of China's urban health care reform.This article summarizes and sorts the policy instruments used in the health care reform;explores the different uses of different policy instruments to different groups;analyzes the factors that influence policy instrument choosing;appraises the impact of policy instruments application;and pictures the tendency of policy instruments application. Based on the summarization and analysis of 30 years' policy instrument application in China's urban health care reform,the author made a policy toolbox for the future health care reform,and tabled some proposal for the policy instrument design in the neo-health care reform.