The policy process and context of the Rural New Cooperative Medical Scheme and Medical Financial Assistance in China

Abstract

A vast amount of research has been carried out on the rural New Cooperative Medical Scheme and Medical Financial Assistance Scheme in China over the past years, but there still exists a gap in the literature, in terms of research of the rural health policy process. This paper tries to answer two questions: what is the rural health policy process like; what are the main dynamics behind this policy process and how did they influence the process?

This paper first reviews the development of the policy process of NCMS and MFA discussing how public concerns emerged and were translated into political issues and how later on in the process, policy alternatives were chosen and legitimated. Implementation and evaluation of policies are also included in this review to give the reader the whole picture of the policy process.

The second part analyzes the dynamics of the rural health policy process, including the impact of economic transition, social structure transition, a change in decision-making model and policy paradigms, health sector reform at macro level, and influences of different stakeholders at micro level.

Conclusions are: rural health policies should take the economic, social and political context into account; non-governmental forces should be developed and united to represent the public interest; a favorable climate for all stakeholders to ‘voice’ their interests has been fostered but there is still a long way to go in developing sustainable formal mechanisms.

Citation

In Issue 23 in the ITM-Antwerp seriesStudies in Health Services Organisation & Policy. Antwerp: Institute of TropicalMedicine. pp. 123-156

The policy process and context of the Rural New Cooperative Medical Scheme and Medical Financial Assistance in China

Published 1 January 2008