Health Reform in China, Russia, and the USA: The Effect of FreeMarket Economies

1
Health Reform in China, Russia, and the USA
The Effect of Free-Market Economies

• Andrew Kersten
• Sociology 572

2
Market-Maximizing Strategy

• Governments failures lead to healthcare problems
• Healthcare is a commodity
• Govt. should limit role in regulation and subsidy
• Competition leads to low prices
• Market is best system to distribute health care

3
Market-Minimizing Strategy

• Market failures limit cost-effective care, i.e.
  can lead to price-fixing
• Govt. imposed benefits, mandates, regulations
• Standardized care for all
• Financing is pre-paid

4
Relationship Between Countries

• China Communist govt. w/market-based health
  care system
• Russia Former Communist govt. trying to
  implement market-based system
• USA Democratic govt. free-market health care,
  but many would like to see market-minimizing/socia
  list program

5
China Urban Health Care
6
Recent Reforms 1998

• Urban workers now covered, including small
  business
• Self-employed and rural industry workers may buy
  into program does not include dependents
• Govt. encourages the purchase of private insurance

7
Outlook

• Rural population became uninsured under
  market-based system 800 million people
• Decentralization of services caused rural health
  care to collapse
• Even w/new insurance scheme, 44 of urban
  population will be uninsured
• China has low health expenditures and low health
  care costs, yet the population is even poorer

8
Russia Debates Without Funding
9
Free-Market vs. Socialist

• 1993 Govt. licensed insurance companies provide
  coverage for workers
• 1995 1996 Members of govt. debate system
  many seek to return to govt.-based care
• 1997 Minister of Health sought out a
  market-minimizing plan, abolishing the current
  structure and placing funding under governmental
  control.

10
Outlook

• Current President Vl. Putin favors market-based
  economy
• Insurance companies favor free-market
• Physicians are split 50/50
• Pro-socialist because of the lack of improvements
  under the new system
• Pro-market because of the chances of increased
  wages
• Little money available for health care low
  priority for funding

11
USA Different Presidents, Different Reforms
12
Clinton Health Plan Market-min

• US reform peaked under Clinton in 92-93
• Plan extended coverage to all un under insured
• Regional health alliances regulated by govt.
• 80 of funding from payroll taxes
• Would regulate care available to population, the
  amount of doctors allowed to practice, i.e. huge
  governmental control over health care
• Would have increased federal spending by 1.6
  trillion
• Cost the avg. family an additional 3000 a year
  in taxes

13
Bush Health Plan Market-max

• Due to problems in Middle East, few health care
  policies have been discussed in congress
• Im absolutely opposed to a national health care
  plan
• Provide refundable tax credits to help uninsured
  buy private insurance would pay for 90 of the
  cost 2000-2500/yr
• Devote 3.6 billion to creation of new health
  centers 158 billion to restructure Medicare
• Critics say tax refunds do little to help pay for
  insurance at an avg. yearly cost of 6300

14
Overall Comparison

• China and Russia do not have a decentralized
  governmental structure that can support a
  market-based health care system at this time
• Neither country has funding to provide health
  care for the entire population
• USA has the money and resources, but there are
  many uninsured
• Re-prioritizing of state and federal budgets
  would help provide health care for the 42 million
  uninsured
• Health care will remain low-priority for the US
  until the next election