A Comparison of the Health Systems in China and India

by Sai Ma, Neeraj Sood

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Abstract

The world's two most populous countries, China and India, are undergoing dramatic demographic, societal, and economic transformations. However, the health status of residents of China and India still lags behind relative to other populations, and the health gains in each country have been uneven across subpopulations. Although they have achieved substantial advances in life expectancy and disease prevention since the middle of the 20th century, the Chinese and Indian health systems provide little protection against financial risk, and patient satisfaction is a lower priority than it should be. This paper compares the health systems of China and India to determine what approaches to improving health in these two countries do and do not work. In particular, the authors compare the health systems in China and India along three dimensions: policy levers, intermediate outcomes, and ultimate ends. The authors conclude that both countries must (1) restructure health care financing to reduce the burden of out-of-pocket medical care costs on individual patients; (2) increase access to care, especially in rural areas; (3) reduce dependence on fee-for-service contracts that promote overutilization of medical care; (4) build capacity for addressing and monitoring emerging diseases; and (5) match hospital capabilities with local needs.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    A Brief History of the Health Systems in China and India

  • Chapter Three

    Overall Performance in Achieving Ultimate Ends

  • Chapter Four

    Intermediate Outcomes: Access, Quality, and Efficiency

  • Chapter Five

    Policy Levers of Health Systems in China and India

  • Chapter Six

    Policy Implications

The research described in this report results from the RAND Corporation's continuing program of self-initiated independent research, which is made possible, in part, by the generous support of donors and by the independent research and development provisions of RAND's contracts for the operation of its U.S. Department of Defense federally funded research and development centers. The research was conducted within the RAND Center for Asia Pacific Policy, part of the International Programs.

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