30
Reforming China’s Rural Health System
Figure 2.11
Impact of Government Health Spending on the Poor and Better Off
Vietnam
Thailand
Indonesia Hong Kong, China, SAR Heilongjiang (China) Gansu (China) –0.4
–0.2
0.0 0.2 0.4 concentration index (negative indicates pro-poor, positive pro-rich)
Source: O’Donnell et al. (2007).24
in Gansu, one of China’s poorest provinces, amounted to just Y 46 per person in 2003; while spending in Shanghai and Tianjin, two of China’s richest provinces, amounted to Y 218 and Y 153, respectively. This is despite the fact that Gansu had much worse health indicators than either Shanghai or Tianjin (Figure 2.12). These inequalities stem from the fact that China’s intergovernmental fiscal system weakened—but did not break—the link between local governments’ per capita income and their available resources for spending.
Challenges and Reforms—Creating a Path Forward These, then, were the challenges that China’s policy makers set out to tackle at the start of the new millennium. Each of the reforms implemented over the period 2003–2007 addressed these difficulties in different but complementary ways. The government has made it clear that the new policies are the start of a longer reform process. In 2007, a high-level government taskforce was charged with preparing a master plan for China’s health sector. In setting up this taskforce, the government was not