Dilemma of healthcare reform and invention of new discipline of health fiscalogy
| Autor: | Dongqi Zhang, Jitong Liu, Jianchun Miao |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Economic growth
medicine.medical_specialty Health (social science) Epidemiology Chinese healthcare reform 010502 geochemistry & geophysics 030226 pharmacology & pharmacy 01 natural sciences 03 medical and health sciences Health fiscalogy 0302 clinical medicine Political science Health care medicine Global health Health policy health care economics and organizations 0105 earth and related environmental sciences Health economics business.industry Health Policy Public health Research Public Health Environmental and Occupational Health International health Governmental responsibility of health Health promotion Health education business |
| Zdroj: | Global Health Research and Policy |
| ISSN: | 2397-0642 |
| Popis: | Background China's Reform and Open up Policy in 1980s has brought rapid economic development to Chinese society. With the deepening of economic reform, the withdrawal of the state in China has had visible and worrisome consequences for health and for the functioning of health services. The new round of healthcare reform after 2009 has made significant achievements on improving fundamental health and bringing back the nature of welfare of health. However, the financing mechanism of health system has not been established, and the underlying reason behind the healthcare reform dilemma and the theoretical solution need to be found. Methods This study used the methods of literature review, theoretical research and comparative research to summarize and analyze the reasons and solutions of current dilemma in healthcare reform, and created the new discipline of health fiscalogy through theoretical analysis and vertical and horizontal comparison of healthcare system, especially health financing. Results Dilemma in healthcare system emerged from the circumstances of rapid process of industrialization, urbanization and population aging, including the profit-driven phenomena, tendency of excessive marketization in public hospitals, strained doctor-patient relationship, high disease burden on individuals and families, and so on. It can be concluded that the theoretical basis of healthcare system and the nature of health resources are crucial in solving the dilemma of healthcare reform. The theoretical basis of healthcare reform should be health fiscalogy focusing on government as the main body of health care responsibility rather than health economics focusing on anti-monopoly. There are two key differences between health economics and health fiscalogy: responsible person/department of disease and health welfare, and nature of resource. The new discipline of health fiscalogy has universal and important implications on both China’s healthcare reform and the healthcare reform in the world. Conclusions China’s healthcare reform should return from the paradigm of health economics and marketization financing model to the paradigm of health fiscalogy and government-led financing model, which is reflected in the main position of government and social welfare. |
| Databáze: | OpenAIRE |
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