After years of intense discussion, deliberation and debate, in April, 2009 China finally unveiled its health care reform plan (Anonymous, 2009;Chen, 2009). President Hu clearly stated that the goal of the reform is to ensure that every citizen has equal access to affordable basic health care by 2012. The recently announced policy explicitly states the government's role in the health care sector for purposes of equity and the provision of public goods, while encouraging the exploration of purchasing, competition and other market mechanisms to improve quality and efficiency. Implicitly, China is searching for the right mix of government and market, a fundamental question that countries around the world are still grappling with.
The Chinese government announced that it will spend an additional 850 billion RMB (USD 125 billion) in the next three years, to provide universal basic health care for its population of 1.3 billion (Anonymous, 2009). The reform is anchored in five specific areas: (1) expand insurance coverage with a target of achieving universal coverage by 2011, with significant demand subsidies for the rural population to enroll in the New Cooperative Medical Scheme (NCMS) and for the urban uninsured to enroll in the Urban Resident Basic Medical Insurance Scheme (URBMI); (2) increase government spending on public health services, especially in lower-income regions; (3) establish primary-care facilities -community health centers in urban areas and township health centers in rural areas, which can serve the gate-keeping function in the long run; (4) reform the pharmaceutical market; and finally, (5) pilot test public hospital reforms.
The principles and objectives have been announced, the priority areas identified and the resources committed. The key question to answer now is: 'are the policies effective in achieving the stated goals, why or why not?'
China's reform decision also calls for turning a new page in the economic studies of China's health care system and policy -a turn from studying the problems of China's health care system under its economic reform during the 1978-2002 period and their root causes, to rigorous and evidence-based evaluation of the impacts of the current reform (post-2002), and equally important, critical and theorybased analyses of the underlying mechanisms of why certain reforms work or do/will not work. The objective of this special issue is to facilitate this transition and focus on the economic evaluation studies for the post-2002 period. These papers represent the beginning, rather than the conclusion, of a new direction of health economics studies for China's health care system.
In response to our call for papers, we received close to 50 submissions and enquiries. Keeping with the goal of this special issue, our selection gave priority to those that answer questions that have not been answered (or adequately answered) before, or raise new questions or use new data sets.