Challenges to the Chinese health insurance system : users' and service providers' perspectives

To achieve universal health insurance coverage, China has launched three phases of health care system reforms. The first round of reforms was embarked on in the mid‑1980s with the introduction of market incentives. The second round began in 1997 with the introduction of the Urban Employee Basic Medical Insurance (UEBMI) scheme which provided health insurance coverage to all urban workers in addition to a long‑term/historical scheme for government workers. Both the government and UEBMI schemes were limited to individual enrolment; however, dependents such as a spouse or child were not covered. The third phase of reforms began in 2003 with the launch of the New Rural Cooperative Medical Care System (NRCMS). This system covers rural residents at the household level. In 2007, the Urban Resident Basic Medical Insurance (URBMI) program was introduced that further expanded the insurance coverage to unemployed urban residents.[1] UEBMI, URBMI, and NRCMS are acknowledged as basic medical insurance (BMI) and all schemes require payment of enrolment premiums.