Abstract:  
This article explores the development of health insurance system in China over the period from 1978 to 2001. The author reviews the implementation of market mechanisms in health insurance system; provides statistical data on the number of insured persons residing in the city or rural localities. Analysis is conducted on legislation that regulates insurance activity in the sphere of medicine. The conclusion is made that the implementation of such systems affected by migration from rural to urban areas led to imbalance in the quality and availability of medical services. It is noted that despite the efforts of Chinese authorities, health insurance system did not expand neither the number of insured rural or urban residents; dependence of the level of medical care on the level of salaries led to segregation of rich and poor citizens. The employees with insufficient salary level were trying to reduce the cost treatment, as it partially compensated from their personal savings, which also led to severe sanitary consequences. Therefore, the implementation of market mechanisms in health insurance led to inequality of the citizens with regards to availability of medical services.
 

Abstract: This article reviews the health insurance reforms in China for the period from 2002 to the present. It stated that 16th National Congress of the Communist Party of China introduced significant amendments to health insurance system, balancing the negative impact of capitalist mechanisms, on the one hand, and justice and equality – on the other. This stage of development in China’s healthcare insurance system is described as the “second generation” in healthcare system, characterized with the change of government’s role in allocation of resources in healthcare sector: proliferation of “wild capitalism” in medicine is replaced with the concept of granting freedom to the market mechanisms under the government supervision. The reforms of PRC government in the area of health have a clear social focus. The state takes over responsibility for health of the citizens, which was released to a free market in the “new course” of the 1980s – 1990s. At the same time, the former paternalistic scheme is replaced by the equal system of interaction between society and the government. In all cases, the insurance funds are formed out of personal deposits of the citizens and deposits of local and central authorities. Municipalities are responsible for majority of decisions in the area of development of insurance schemes. The government’s role consists in establishment of minimum deposits and maximum coverage. This is how the central authorities, local administration and citizens are involved in insurance schemes on equal terms.

Abstract: From the historical perspective, this article explores the establishment of the system of state medical insurance in China. The historical period of this establishment was selected due to an abrupt change in the system of medical insurance as a result of creation of the People’s Republic of China – the system of medical insurance changed from private to state-controlled. Prior to 1949, insurance was issued by private companies, then replaced by state medical insurance. This article gives attention to the key points in establishment of the system of medical insurance, as well as examines the main legislative bills that served as the basis for creation of the state insurance system. The author substantiates the idea of the periodicity of the development of China’s system of social medical insurance. The history of development of this system includes three stages: each of which is tightly connected to a specific strategy of socioeconomic development of PRC authority. Attention is also paid to redistribution of resources of the system of medical insurance between a city and a village, which vividly reflects the need for adjustment of the system of medical insurance to China’s rapid industrialization in that chronological period. The author describes the flaws of the system and government actions aimed at their overcoming.