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Research on the policy process of the New Cooperative Medical Scheme and Medical Assistance scheme in China

Date: Poster sessions
Source: Forum 11
Authors: Wang Yunping, Assistant Researcher, China Health Economics Institute, People's Republic of China


There are two main formal institutions in China for accessing health services for rural residents, the poor and vulnerable populations: 1) the New Cooperative Medical Scheme (NCMS); and 2) the Medical Assistance scheme (MA). Although plenty of research has been done on NCMS and MA, both in China and abroad, since the two schemes came into effect, there is still a gap in the rural health policy process from the viewpoints of politics and public management.

Taking NCMS and MA as examples, this paper discusses the policy process for rural health, including the following questions: 1) What were the problems of rural health and how did knowledge of equitable rural health access improve? 2) How did issues of rural health come onto the central government's health policy agenda? 3) How were the designs of NCMS and MA chosen? 4) What were the effects, problems and pressures in policy implementation? 5) What are the trends in policy adjustment and innovation.

By exploring the dynamic sequential policy process, we find that economic transition, social innovation, change of political ideas and values, the policy network, and health reforms have had significant influences on the rural health policy process.

This study concludes that: 1) the extent of economic and social development is a precondition for rural health policies; 2) the attention of senior policy-makers to rural health is a crucial factor; 3) the interest of implementers and the coordination among different departments are critical factors in the sustainable development of health policies; 4) researchers and other stakeholders are an important force in providing policy-makers with realistic information on health problems, getting policies enacted and improved. If any innovations in rural health policies are contemplated, we must take into account the above four conditions.