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CANADA Health Council of Canada (2013). “How Do Canadian Primary Care Physicians Rate the Health System? Survey Results from the 2012 Commonwealth Fund International Survey of Primary Care Doctors.” Toronto: Health Council of Canada. Henry, D. A., S. E. Schultz, R. H. Glazier, R. S. Bhatia, I. A. Dhalla, and A. Laupacis (2012). “Payments to Ontario Physicians from Ministry of Health and Long-Term Care Sources 1992/93 to 2009/10.” Toronto: Institute for Clinical Evaluative Sciences. Liberal Party of Canada. (2015). “A New Plan for a Strong Middle Class.” https://www.liberal.ca/realchange/. Accessed Oct. 30, 2015. Marchildon, G. P. (2013). Canada: Health System Review. Copenhagen: WHO Regional Office for Europe on Behalf of the European Observatory on Health Systems and Policies. National Physician Survey, 2014. The College of Family Physicians of Canada, Canadian Medical Association, The Royal College of Physicians and Surgeons of Canada. http://nationalphysiciansurvey.ca/wp-content/uploads/2014/11/2014- National-EN.pdf. Accessed Aug 1, 2015. Ogilvie, K. K., and Eggleton, A. (2012). Time for Transformative Change: A Review of the 2004 Health Accord. Ottawa, Ontario: The Standing Senate Committee on Social Affairs, Science and Technology. Ontario Ministry of Health and Long-Term Care (MOHLTC) (2011). Info Bulletin. http://www.health.gov.on.ca/en/pro/ programs/ohip/bulletins/11000/bul11020.pdfhttp://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/11000/bul11020. pdf. Access Oct. 30, 2015. Ontario Ministry of Health and Long-Term Care (MOHLTC) (2014). “Hospitals. Questions and Answers.” http://www.health. gov.on.ca/ en/common/system/services/hosp/faq.aspx. Accessed Oct. 1, 2014. Ontario Ministry of Health and Long-Term Care (MOHLTC) (2009). “Guide to Physician Compensation.” http://www.health. gov.on.ca/en/pro/programs/fht/docs/fht_compensation.pdf (Accessed Aug. 30, 2015). Organization for Economic Cooperation and Development (OECD) (2015). OECD.Stat. DOI: 10.1787/data-00285-en. Accessed July 2, 2015. Organization for Economic Cooperation and Development (OECD) (2014). “Health Data, 2014.” Paris: OECD. Organization for Economic Cooperation and Development (OECD) (2011). “Long-Term Care.” Paris: OECD. Public Health Agency of Canada (2011). “Reducing Health Inequalities: A Challenge for Our Times.” Ottawa: Public Health Agency of Canada. Rudoler, D., A. Laporte, J. Barnsely, R. H. Glazier, and R. B. Deber (2014). “Paying for Primary Care: A Cross-Sectional Analysis of Cost and Morbidity Distributions Across Primary Care Payment Models in Ontario, Canada” (unpublished manuscript). Institute of Health Policy, Management and Evaluation, University of Toronto. Statistics Canada. (2011). “Residential Care Facilities: 2009/10.” Ottawa: Statistics Canada Catalogue, no.83-237-X. http:// www.statcan.gc.ca/pub/83-237-x/83-237-x2012001-eng.pdf. Accessed Aug. 29, 2015. Stukel, T., R. H. Glazier, S. E. Schultz, J. Guan, B. M. Zagorski, P. Gozdyra, and D. A. Henry (2013). “Multispecialty Physician Networks in Ontario.” Open Medicine 7:2. Sutherland, J. M., R. T. Crump, N. Repin, and E. Hellsten (2013). “Paying for Hospital Services: A Hard Look at the Options.” Toronto: C. D. Howe Institute. Sutherland, J. M., N. Repin, and R. T. Crump (2013b). “The Alberta Health Services Patient/Care–Based Funding Model for Long-Term Care: A Review and Analysis.” British Columbia: Centre for Health Services and Policy Research. Sweetman, A., and G. Buckley (2014). “Ontario’s Experiment with Primary Care Reform.” The University of Calgary School of Public Policy Research Papers 7(11):1–37. http://www.policyschool.ucalgary.ca/sites/default/files/research/ontario-health-carereform.pdf. Accessed Oct. 10, 2014. 30 The Commonwealth Fund
The Chinese Health Care System, 2015 Hai Fang Peking University What is the role of government? In China, the central government has overall responsibility for national health legislation, policy, and administration. It is guided by the principle that every citizen is entitled to receive basic health care services, with local governments—provinces, prefectures, cities, counties, and towns—responsible for providing them according to local circumstances. Health authorities include the National Health and Family Planning Commission and the local Health and Family Planning Commissions (or Bureaus of Health, if they have not been merged with local Family Planning Commissions), which have primary responsibility for organizing and delivering health care and supervising providers (mainly hospitals). Health authorities at the prefectures/city, county, and town levels have limited flexibility in carrying out provincial health policies. Who is covered and how is insurance financed? Generally, health insurance is publicly provided and financed by local governments. Publicly financed health insurance: In 2013, China spent approximately 5.6 percent of its gross domestic product (CNY3,187B, or USD871B) on health care, with 30 percent financed by local governments and 36 percent by publicly financed health insurance, private health insurance, or social health donations (National Health and Family Planning Commission, 2014). There were three main types of publicly financed insurance: 1) urban employment-based basic insurance (launched in 1998); 2) urban resident basic insurance (launched in 2009); and 3) the new cooperative medical scheme for rural residents (launched in 2003). Urban employment-based basic insurance is mainly financed from employee and employer payroll taxes, with minimal government funding. Participation is mandatory for employees in urban areas; the insured population was 274.2 million in 2013 (National Health and Family Planning Commission, 2014). Employees’ nonemployed family members are not covered. Urban resident basic insurance, which is voluntary at the household level, covered 299 million self-employed individuals, children, students, and elderly adults in 2013. Both urban employment-based and urban resident insurance are administered by the Ministry of Human Resources and Social Security and run by local authorities. The new cooperative medical scheme, mainly administered by the National Health and Family Planning Commission and run by local authorities, is also voluntary at the household level and covered a rural population of 802 million in 2013, representing a coverage rate of 98.7 percent. Urban resident basic insurance and the new cooperative medical scheme are mainly government financed. In regions where the economy is less developed, the central government provides the largest share of subsides, with provincial and prefectural governments providing the rest. In more-developed provinces, most government subsidies are locally provided (mainly provincial). Coverage of publicly financed health insurance is nearuniversal—exceeding 95 percent of the population since 2011 (Jiang and Ma, 2015). The few permanent foreign residents are entitled to the same coverage benefits as citizens. Undocumented immigrants (there are very few) and visitors are not covered by publicly financed health insurance. 1 Please note that, throughout this profile, all figures in USD were converted from CNY at a rate of about CNY3.66 per USD, the purchasing power parity conversion rate for GDP in 2014 reported by OECD (2015) for China. International Profiles of Health Care Systems, 2015 31
Page 1 and 2: JANUARY 2016 2015 International Pro
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Page 13 and 14: AUSTRALIA low-income adults, childr
Page 15 and 16: AUSTRALIA In 2013, the federal gove
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Page 19: References AUSTRALIA Australian Bur
Page 22 and 23: CANADA What is covered? Services: T
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Page 38 and 39: CHINA References Chen, X. (2014).
Page 40 and 41: DENMARK In addition, nearly 1.5 mil
Page 42 and 43: DENMARK Social psychiatry and care
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Page 50 and 51: ENGLAND immunization, and vaccinati
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Page 60 and 61: FRANCE VHI finances 13.8 percent of
Page 62 and 63: FRANCE The average income of primar
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Page 66 and 67: FRANCE inequities in prevention rel
Page 68 and 69: FRANCE Nolte, E., C. Knai, and M. M
Page 70 and 71: GERMANY There were 42 substitutive
Page 72 and 73: GERMANY The 16 state governments de
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INDIA provide after-hour care, reim
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INDIA are provided by other ministr
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INDIA How are costs contained? Ther
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ISRAEL Together, these two types of
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ISRAEL Primary care physicians are
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ISRAEL Organization of the Health S
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ISRAEL • Using electronic health
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ITALY during hospitalization (Thoms
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ITALY Some regions are promoting ca
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ITALY Organization of the Health Sy
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ITALY although the degree of evolut
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ITALY The author would like to ackn
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JAPAN What is covered? Services: Al
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JAPAN incentives for providers to c
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JAPAN Organization of the Health Sy
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JAPAN The author would like to ackn
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THE NETHERLANDS receive faster acce
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THE NETHERLANDS Hospital payment ra
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THE NETHERLANDS Organization of the
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THE NETHERLANDS References Organisa
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NEW ZEALAND provided in GP clinics.
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NEW ZEALAND management (e.g., clean
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NEW ZEALAND including such informat
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NEW ZEALAND largely through efficie
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NORWAY Primary, preventive, and nur
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NORWAY Patients are free to choose
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NORWAY What are the major strategie
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NORWAY The National System for the
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SINGAPORE Medifund is the governmen
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SINGAPORE Public hospital funding i
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SINGAPORE Public consultation: The
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SINGAPORE To keep demand for servic
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SWEDEN What is covered? Services: T
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SWEDEN Hospitals: There are seven u
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SWEDEN Care, which promotes use of
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SWEDEN What major innovations and r
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SWITZERLAND Insurers offer premiums
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SWITZERLAND Hospitals: About 70 per
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SWITZERLAND Organization of the Hea
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SWITZERLAND To control pharmaceutic
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UNITED STATES What is covered? Serv
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UNITED STATES Administrative mechan
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UNITED STATES The Institute of Medi
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UNITED STATES adopted at least a ba
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The COMMONWEALTH FUND Affordable, q
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