Policy Insight, Volume 2, Issue 3, June 2008

Caring for a Third of the World's Population: Challenges for the Health Systems of China and India

by Sai Ma, Neeraj Sood

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Despite significant gains over the last 50 years, China and India — which, together, are home to more than a third of the world's population — still lag behind many countries on key measures of health. This Policy Insight compares the health systems of the two countries, highlighting the challenges common to both nations as well as those that are distinct to each of them. Such a comparison is timely, as health care reform is high on the political agenda of both countries. Ma and Sood note that while China has relied more on government provision of health services and India has turned more to the private sector, health care in both countries is financed heavily by individual out-of-pocket spending, and health insurance is much less common than in the United States or Europe. Since the costs and financial risks associated with health care are not pooled, heavy financial burdens are placed on the poor and the sick, and health care costs are an increasing cause of poverty in both countries. In addition, the increasing privatization of health care in both countries contributes to overutilization of some services and a harmful emphasis on curative rather than preventative care. The authors discuss several ways in which China and India can reform their health systems to better meet their peoples' needs.

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