Conclusion and Discussion

  • Carine Milcent


As a conclusion to this book, the Chinese population is categorized into three subgroups that are likely to represent the demand side of three very different healthcare markets in the future:
  • A very disadvantaged population with a very low income that cannot afford healthcare access, even for basic healthcare, without the support and intervention of the state. This population is composed of those who benefit from Medical Assistance but also who are eligible for the two main public insurance schemes, namely the New Rural Cooperative Medical Insurance scheme and the Urban Residence Basic Medical Insurance scheme. This population is mainly from rural areas but with a growing element from urban locations;

  • An intermediate level of population with income sufficient to afford access to basic healthcare but who cannot afford the whole package of healthcare offered. This population has, over the past three decades, experienced an amazing change in their healthcare quality preference. The level of quality required to satisfy their demand has increased highly. In the 1980s, considered here as the initial context, they were satisfied with a poor level of quality for almost free access. Nowadays, they look for qualified and trained physicians working in well-equipped hospitals. This population is willing to pay a substantial healthcare cost to get the level of quality it rates as necessary. For this population, severe pathology or chronic disease can lead to impoverishment and deterioration in the quality of life;

  • A high-income population able to subscribe to a private insurance policy. This population mostly lives in urban locations. On the one hand, the level of quality requested to satisfy this audience is high. On the other hand, this population can afford to access a certain level of healthcare without the support of public health insurance. This population is the one targeted by commercial private insurance companies. These firms offer them supplementary insurance in addition to the public health insurance package.


Disadvantaged population Income inequity Urban/rural locations Healthcare access Health insurance package Willingness-to-pay Future healthcare markets 


  1. Hougaard, J.L., L.P. Osterdal, and Y. Yu, “The Chinese Healthcare System: Structure, Problems and Challenges,” Applied Health Economics and Health Policy, Vol. 9, No. 1, 2011, pp. 1–13.Google Scholar
  2. “Industry Report, Healthcare: China,” The Economist Intelligence Unit, August 2014.Google Scholar
  3. Long, Q., L. Xu, H. Bekedam, and S. Tang, “Changes in Health Expenditures in China in 2000s: Has the Health System Reform Improved Affordability?” International Journal for Equity in Health, Vol. 12, 2013, p. 40.Google Scholar
  4. Moe, Jeffrey, Shu Chen, and Andrea Taylor, “Initial Findings in a Landscaping Study of Healthcare Delivery Innovation in China,” IPIHD (International Partnership for Innovative Healthcare Delivery) Research Report 14-01, 2014.Google Scholar
  5. Qin, Xuezheng, Lixing Li, and Chee-Ruey Hsieh, “Too Few Doctors or Too Low Wages? Labor Supply of Healthcare Professionals in China,” China Economic Review, Vol. 24, No. 1, 2013.Google Scholar
  6. World Bank, “Urban China: Toward Efficient, Inclusive, and Sustainable Urbanization,” Development Research Centre of the State Council, Source MoH, 2011.Google Scholar
  7. Yip, W., W. Hsiao, W. Chen, S. Hu, J. Ma, and A. Maynard, “Early Appraisal of China’s Huge and Complex Health-care Reforms,” Lancet, Vol. 379, No. 9818, 2012, pp. 833–842.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Carine Milcent
    • 1
  1. 1.CNRS and Paris School of Economics (PSE)ParisFrance

Personalised recommendations