Posts tagged ‘Health care’


China to expand medical insurance for major illnesses | Reuters

China will expand medical insurance to cover all critical illnesses for all urban and rural residents by the end of the year, the cabinet said on Sunday, the latest step in a plan to fix a healthcare system that has sparked public discontent.

The State Council said 50 percent of the medical costs will be covered by insurance in a bid to “more effectively reduce the burden of medical expenses”, in a statement posted on the government’s website.

President Xi Jinping‘s government has touted access to affordable healthcare as a key platform of his administration, underscoring the importance of meeting the needs of the nearly 1.4 billion people, many of whom have often complained of large out-of-pocket expenses due to low levels of insurance coverage.

Many people say the cost of serious illnesses such as cancer and diabetes can bankrupt households under the current system.

The aim of expanding health insurance was to “effectively alleviate poverty caused by illness” and to build a strong universal healthcare system, the State Council said.

Since 2009, China has spent 3 trillion yuan ($480 billion) on healthcare reform, but the system still struggles with a scarcity of doctors, attacks by patients on medical staff and a fragmented drug distribution and retail market.

Economists say it is crucial for China to improve the quality of its healthcare if it wishes to remake its economy and boost domestic consumption. They say a stronger safety net will encourage Chinese to spend more and save less.

China’s healthcare spending is set to hit $1 trillion by 2020, up from $357 billion in 2011, according to McKinsey & Co, attracting a rapid inflow of money from private insurers, hospital operators and other investors.

via China to expand medical insurance for major illnesses | Reuters.


Primary care centres key to reforming healthcare in India: health economist Kenneth Thorpe

Over 60 percent of deaths in India are due to non-communicable diseases (NCDs) such as cancer, diabetes, chronic respiratory diseases and cardiovascular disease, which are also responsible for about 70 percent of spending on healthcare. They also affect the economic health of the country, with NCDs and mental illness expected to cost India $4.58 trillion between 2012 and 2030.

Health economist Dr. Kenneth E. Thorpe, chairman of Partnership to Fight Chronic Disease, an international NGO, is advising the government of India on developing a policy to deal with the country’s rising chronic disease problem.

In an interview with India Insight, Thorpe shared his thoughts on how India can reform its healthcare delivery system, the need to replicate successful models of primary health centres to cover the entire country, and why payments for health services need to be changed from out-of-pocket expenses to a subscription-based system and through insurance.

Q: Why should India focus on non-communicable diseases (NCDs)?

A: NCDs account for over 60 percent of deaths in India. It’s also a major driver of health spending – 60 to 70 percent of what India spends on healthcare is linked to NCDs. It’s a major problem not just in terms of healthcare but also in terms of productivity.

Q. Which sector is more crucial to improving healthcare delivery in India – government or private?

A: Both. It’s got to be a public-private partnership. So today, India spends about 4 percent of its GDP on healthcare. About one-and-a-half percent of that is the government and the rest is private. So we just need to scale that up – probably proportionally to something like 5 or 6 percent of GDP.

Q: In what way are you working with the Indian government?

A: We’re working on developing a policymaking framework for healthcare reform solution for India.

Q. Has there been any progress?

A: With the Modi government coming in, there was a renewed interest in developing something as a health policy solution for India. They seem very receptive to some of the things that we’re talking about in terms of preventing chronic disease and treating patients that have chronic disease.

Q: What have you been able to achieve?

A: We were here in December and the ministers asked us to put together a blueprint of what would a healthcare reform look like. And so we put together some thoughts that they basically incorporated into their blueprint (National Health Policy) in February. That’s like an outline, so the next point is saying: “How do we operationalise this outline?”

Q: What have you proposed in your blueprint?

A: One is that we really need to build up the primary care infrastructure. We need more manpower, more hospital beds, but we really need capacity – building up primary care clinics, primary care models that really deal with identifying chronic disease, preventing it and managing it. And there are some good models that we’ve identified throughout the country that we think we can scale them and replicate them throughout India.

Q: Are you saying that the main focus should be on primary healthcare centres?

A: That’s the biggest challenge. That’s the starting place. We need to build from the ground up.

Q: And majority of scaling up will have to come from the private sector?

A: I think one of our messages is that the government can’t do this alone. It just doesn’t have the resources to really build the system and build the infrastructure. It’s going to need private sector investment as well. So we’re trying to figure out how we can harness some of the private sector money and help build a healthcare delivery system and potentially a bigger healthcare insurance system.

Q: Where does the government come in?

A: The government has to play a role in funding, particularly low-income populations – the poor that live in rural areas, urban poor.

Q: What else?

A: Manpower training, more doctors and nurses …

Q: Can the government help in nudging private players to increase their participation, especially in rural areas?

A: The government’s got to play a leadership role and say: “Here’s where we are going, here’s the plan, here’s the framework, the blueprint. We’ll work with the states in order to implement this.”

But we need to sort of change the way that healthcare services are paid for. So today in India, 60 percent of spending is out of pocket. So we need to change that from out-of-pocket buying to something like a primary care package (subscription) or an insurance product.

Q:  Very few people in India have health insurance, and health policies have a very limited coverage.

A: I think the insurance model needs to be completely changed. Private insurance covers just 2 percent of the population and it covers only in-patient hospital care. And the problem is that most of these chronic diseases need primary care, medications, home community-based services – things that are not covered in current insurance policies.

Q: Where does India stand on the problem of NCDs as compared to other developing countries?

A: The challenge India faces is its ability to manage and deal with it is way below the average because the capacity is not there, the infrastructure is not there, the manpower is not there, the investment is really not there.

via Primary care centres key to reforming healthcare in India: health economist Kenneth Thorpe.


China aims to double doctor numbers as cure for healthcare woes | Reuters

China will almost double the number of its general doctors by 2020, trim its public sector and improve technology as it seeks to fix a healthcare system plagued by snarling queues and poor rural services, its main administrative authority has said.

People queue at a hospital in Shanghai, September 2, 2014.  REUTERS/Aly Song

China’s fast-growing healthcare market is a magnet for global drug makers, medical device firms and hospital operators, all looking to take a slice of a healthcare bill expected to hit $1 trillion by 2020, according to McKinsey & Co.

“Healthcare resources overall are insufficient, quality is too low, our structures are badly organized and service systems fragmented. Parts of the public hospital system have also become bloated,” China’s State Council said in a five-year roadmap announced late on Monday.

The roadmap, which laid out targets for healthcare officials nationwide between 2015 and 2020, said Beijing wanted to have two general doctors per thousand people by 2020, close to double the number at the end of 2013, as well as increasing the number of nursing and support staff.

China suffers from a scarcity of doctors – partly caused by low salaries – which has created bottlenecks at popular urban hospitals leading to rising tension between medical practitioners and often frustrated patients.

The roadmap said China would also look to use technology such as mobile devices and online “cloud systems” to meet some of the issues, a potential boost to tech firms like Alibaba Group Holding Ltd and its healthcare subsidiary Alibaba Health Information Technology Ltd.

China should also have digital databases for electronic health records and patient information covering the entire population to some degree by 2020, it said.

Providing access to affordable healthcare is a key platform for President Xi Jinping‘s government. However, recent probes have turned the spotlight on corruption in the sector, while patients often have large out-of-pocket expenses due to low levels of insurance coverage.

The roadmap said China would push forward the development of grassroots healthcare, a fast-growing business segment, while reining in some large public hospitals in urban centers.

The document also suggested further opening to the private sector, where Chinese and international firms have been taking a growing role in running hospitals.

“The role of public health institutions is too big, with the number of beds accounting for around 90 percent of the total,” the State Council said.

via China aims to double doctor numbers as cure for healthcare woes | Reuters.


What the Budget Means for Regular Indians – India Real Time – WSJ

The Modi government’s budget offered some sops for middle-class tax payers and a series of steps aimed at boosting social security for the country’s poor.

Tax Breaks on Health Insurance, Travel: Individuals will be allowed to deduct up to 25,000 rupees ($400) annually in health-insurance premiums from their taxes. That is an increase from the current 15,000-rupee deduction. For people 60 years or older, the deduction will be 30,000 rupees.

Mr. Jaitley also proposed increasing the amount of transportation expenses individuals can deduct to 1,600 rupees a month, up from 800 rupees a month now.

Pension Deduction: Individuals can now claim an additional tax deduction of up to 50,000 rupees ($800) if they put the money in the government’s New Pension Scheme. “This will enable India to become a pensioned society instead of a pensionless society,” said Mr. Jaitley.

Social Security programs: In a bid to provide a social safety net, Mr. Jaitley said the state will provide accidental death insurance of 200,000 rupees for a premium of just one rupee a month. State insurers will also offer policies covering natural and accidental death for 330 rupees a year.

Though available to all, the relatively small size of the insurance cover implies these will likely be used mostly by the poor.

The government will also encourage individuals to set up pension accounts under a new program. For individuals who open such an account by Dec. 31, the government will match individual contributions up to 1,000 rupees a year, for five years.

Tax-Free bonds:  Mr. Jaitley plans to allow government agencies and others to issue tax-free infrastructure bonds to fund roads, railways and irrigation. Details weren’t disclosed but typically interest on such bonds is tax free.

Service Tax: Now for the bad news: your restaurant and phone bills will soon go up, because the government will raise the service tax to 14% from 12.4%. Individuals indirectly pay this tax on a wide range of services, including on insurance premiums, hotel bills and electricity bills.

Gold Bonds: Since Indians won’t give up their love for gold, Mr. Jaitley tried to come up with ways to at least get it out of people’s homes and into banks. He introduced a plan that he said would make it easier for people keep gold in a bank, earn interest on it and borrow against it.

Mr. Jaitley also proposed a “Sovereign Gold Bond” that would act as an alternate to owning physical gold. These bonds would have a fixed rate of interest and “be redeemable in cash in terms of the face value of the gold,” he said.

Unaccounted-for Money: Mr. Jaitley said the government would introduce more stringent requirements for people to declare assets held overseas and make it harder for people to buy real-estate with cash in an effort to tax evasion.

via What the Budget Means for Regular Indians – India Real Time – WSJ.


Improving health care: Congratulations! Inoculations! | The Economist

FANS of the China model frequently say that, for all the disadvantages of a one-party state, there are also benefits. Enforcing basic health care is one—and by no means a small one. Last year China’s mortality rate for children under five years old was just one-fifth the rate it was in 1991, down from 61 deaths per 1,000 live births to 12. The maternal mortality rate has also dropped substantially—by 71%—since 1991. In 1992, one in ten Chinese children under five contracted hepatitis B. Today fewer than one in 100 of them carry the disease.

China’s advances have not gone unnoticed. Last month a group of four international bodies, including the World Health Organisation (WHO) and the World Bank, said China was one of ten countries to have made exceptional progress in reducing infant and maternal mortality (see chart). Not all of the ten—which included Egypt, Peru, Bangladesh and Vietnam—are one-party states.

China’s improvement lies in two basic, connected areas: better care at birth and countrywide immunisation. Since 2000 the government has offered subsidies to mothers who give birth in hospitals, thereby reducing health dangers from complications—especially the risk of neonatal tetanus. The scheme also brought hard-to-reach people and groups into contact with the health-care system.

From 2001 to 2007, the share of births that took place in hospitals rose by 46%, making it easier to give a hepatitis B vaccine immediately. China now has one of the highest usage rates of the birth dose of the vaccine in the world: 96% of Chinese babies receive it on their first day of life. In 2012 the WHO commended China for a “remarkable” public-health achievement. That year it declared China free of maternal and neonatal tetanus.

Margaret Chan, the WHO’s director-general, this month said that China’s regulatory system for vaccines had passed the WHO’s evaluation with outstanding results. Dr Chan says she has “full confidence” in the safety of vaccines made in China. Last year the WHO approved one for the first time for use by UNICEF. (That has not dispelled suspicions within China itself, however, about the safety of Chinese vaccines.) China and the WHO claim that about 95% of children are vaccinated for measles, rubella and polio. In 2008 the government added eight new vaccines, including hepatitis A and meningitis, to its national programme. All are administered to children free of charge. Just as important has been the mobilisation of a network of health-care workers, at provincial, county and township levels.

via Improving health care: Congratulations! Inoculations! | The Economist.

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