Camb Q Healthc Ethics. 2018 Jul;27(3):447-458. doi: 10.1017/S0963180117000834.

Ethical Reflections on the Equity of the Current Basic Health Insurance System Reform in China: A Case Study in Hunan Province.

Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees

Junxiang Liu, Jingzi Xu, Tianyu Zhang, Yonghui Ma

PMID: 29845918 DOI: 10.1017/S0963180117000834

Abstract

China's current basic health insurance reform aims at promoting equity in the economic accessibility of health services for all citizens, to better ensure healthcare justice. Therefore, it is important to assess equity not only from a socioeconomic perspective but also from an ethical angle. This article investigates the basic health insurance system of Hunan Province in China by focusing on insurance types as well as their classification standards, mechanisms, and utilization according to local policy documents and data. This study demonstrates the reforming achievements and the inequity of institutional design according to two interrelated dimensions: equal opportunity of access to healthcare insurance and reducing inequality in insurance benefits. The article concludes that to achieve opportunity equity and outcome fairness, the reform should focus on designing the system to promote equity with respect to procedures and rules and to be more attentive to the interests of vulnerable groups and especially to rural residents.

Keywords: basic health insurance; equal opportunity; equity; outcome fairness; procedural justice; universality

MeSH terms

• China
• Health Care Reform*
• Health Services Accessibility
• Healthcare Disparities
• Insurance, Health / organization & administration
• Rural Population

Publication Types

• Journal Article