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Regulating private medical institutions: a case study of China

Published online by Cambridge University Press:  23 August 2019

Ziyu Liu
Ziyu Liu*
Affiliation:
Law & Health Care, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
*
Corresponding author. Email: [email protected]
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Abstract

The expansion of privatisation in health care has been discussed extensively in most European countries and remains a hot topic nowadays. In China, privatisation results in considerable changes in its health care system, especially accelerating the ever-growing private medical institutions (PMIs). The rapid growth of PMIs raises the question of regulation for the Chinese government. Given the fact that few studies are available on the regulation of PMIs in China, I attempted to fill that gap by discussing the development of PMIs with a special focus on legal–regulatory strategies. After assessing current legal–regulatory strategies concerning PMIs, the paper identifies three major concerns regarding effective legal rules (i.e. weak coherence, inconsistency and legislative vacancy) and three difficult issues regarding government capacity (i.e. the negative effects of decentralised political structure, the low professionalism of bureaucrats and lack of reliability) that impede the well-functioning of regulatory agencies in China. As a plausible response, the paper recommends that the newly drafted basic health law should assign a separate chapter to regulate PMIs and also an independent regulatory body should be established to manage the issues of PMIs in China. Detailed recommendations are the practical implications of ICESCR General Comment No. 14.

Keywords

ChinaInternational human rights lawprivate medical institutionsprivatisationregulation
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Issue 2 , April 2021 , pp. 124 - 137
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Copyright
Copyright © Cambridge University Press 2019

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References

Albreht, T (2009) Privatization processes in health care in Europe – a move in the right direction, a ‘trendy’ option, or a step back? European Journal of Public Health 19, 448–450.CrossRefGoogle ScholarPubMed
André, C and Batifoulier, P (2016) Health care privatization in Europe: theoretical justifications and empirical classification. International Social Security Review 69, 3–23.CrossRefGoogle Scholar
Barlow, J, Roehrich, J and Wright, S (2013) Europe sees mixed results from public-private partnerships for building and managing health care facilities and services. Health Affairs 32, 146–154.CrossRefGoogle ScholarPubMed
Bloche, MG (2005) Is privatization of health care a human rights problem? In Feyter, KD and Isa, FG (eds), Privatization and Human Rights: In the Age of Globalization. Antwerp and Oxford: Intersentia, pp. 207–227.Google Scholar
Bloom, G (2001) Equity in Health in unequal societies: meeting health needs in contexts of social change. Health Policy 57, 205–224.CrossRefGoogle ScholarPubMed
Blumenthal, D and Hsiao, W (2005) Privatization and its discontents – the evolving Chinese health care system. New England Journal of Medicine 353, 1165–1170.CrossRefGoogle ScholarPubMed
Blumenthal, D and Hsiao, W (2015) Lessons from the East – China's rapidly evolving health care system. New England Journal of Medicine 372, 1281–1285.CrossRefGoogle ScholarPubMed
Chapman, A (2014) The impact of reliance on private sector health services on the right to health. Health and Human Rights 16, 122–133.Google ScholarPubMed
Daniels, N (1996) Just and Justification: Reflective Equilibrium in Theory and Practice. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Daniels, N (2001) Justice, health and healthcare. American Journal of Bioethics 1, 20–14.CrossRefGoogle ScholarPubMed
Feyter, KD and Isa, FG (2005) Privatization and human rights: an overview. In Feyter, KD and Isa, FG (eds), Privatization and Human Rights: In the Age of Globalization. Antwerp and Oxford: Intersentia, pp. 1–7.CrossRefGoogle Scholar
Fuller, LL (1969) The Morality of Law, revised Edn. New Haven and London: Yale University Press.Google Scholar
Graham, C (2005) Human rights and the privatization of public utilities and essential services. In Feyter, KD and Isa, FG (eds), Privatization and Human Rights: In the Age of Globalization. Antwerp and Oxford: Intersentia, pp. 33–55.Google Scholar
Hayek, F (1945) The use of knowledge in society. American Economic Review 35, 519–530.Google Scholar
Havighurst, CC (2003) American health care and the law. In Bloche, MG (ed.), The Privatization of Health Care Reform: Legal and Regulatory Perspectives. New York: Oxford University Press, pp. 1–21.Google Scholar
Horton, R and Clark, S (2016) The perils and possibilities of the private health sector. Lancet 388, 540–541.CrossRefGoogle ScholarPubMed
Kozinski, A and Bentz, A (2013) Privatization and its discontents. Emory Law Journal 63, 263–282.Google Scholar
Larsen, LT (2015) Governing health care through free choice: neoliberal reforms in Denmark and the United States. Journal of Health Politics, Policy and Law 40, 941–970.CrossRefGoogle ScholarPubMed
Liu, D and Darimont, B (2013) The health care system of the People's Republic of China: between privatization and public health care. International Social Security Review 66, 97–116.CrossRefGoogle Scholar
Liu, G, Liu, X and Meng, Q (1994) Privatization of the medical market in socialist China: a historical approach. Healthy Policy 27, 157–174.CrossRefGoogle ScholarPubMed
Maarse, H (2006) The privatization of health care in Europe: an eight-country analysis. Journal of Health Politics, Policy and Law 31, 981–1014.CrossRefGoogle ScholarPubMed
Mackintosh, M, Channon, A, Karan, A, Selvaraj, S, Cavagnero, E and Zhao, H (2016) What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries. Lancet 388, 596–605.CrossRefGoogle ScholarPubMed
Marshall, M and Bindman, AB (2016) The role of government in health care reform in the United States and England. JAMA Internal Medicine 176, 9–10.CrossRefGoogle ScholarPubMed
McPake, B and Hanson, K (2016) Managing the public-private mix to achieve universal health coverage. Lancet 388, 622–630.CrossRefGoogle ScholarPubMed
Meng, Q, Yang, H, Chen, W, Sun, Q and Liu, X (2015) People's Republic of China: health system review. Health Systems in Transition 5, 29–32.Google Scholar
Mills, A (2014) Health care systems in low- and middle-income countries. New England Journal of Medicine 370, 552–557.CrossRefGoogle ScholarPubMed
Mills, A, Brugha, R, Hanson, K and McPake, B (2002) What can be done about the private health sector in low-income countries? Bulletin of the World Health Organization 80, 325–330.Google ScholarPubMed
Minow, M (2003) Public and private partnerships: accounting for the new religion. Harvard Law Review 116, 1229–1270.CrossRefGoogle Scholar
Montagu, D and Goodman, C (2016) Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector? Lancet 388, 613–621.CrossRefGoogle ScholarPubMed
Morgan, R, Ensor, T and Waters, H (2016) Performance of private sector health care: implications for universal health coverage. Lancet 388, 606–612.CrossRefGoogle ScholarPubMed
Nichols, LM, Ginsburg, PB, Berenson, RA, Christianson, J and Hurley, RE (2004) Are market forces strong enough to deliver efficient health care systems? Confidence is waning. Health Affairs (Millwood) 23, 8–21.CrossRefGoogle ScholarPubMed
Ramesh, M and Wu, X (2009) Health policy reform in China: lessons from Asia. Social Science & Medicine 68, 2256–2262.CrossRefGoogle ScholarPubMed
Roberts, M, Hsiao, W, Berman, P and Reich, M (2008) Getting Health Reform Right: A Guide to Improve Performance and Equity. New York: Oxford University Press.CrossRefGoogle Scholar
Roehrich, J, Barlow, J and White, S (2013) Delivering European healthcare infrastructure through public-private partnerships: the theory and practice of contracting and bundling. In Das, TK (eds), Series: ‘Research in Strategic Alliances’, Book: ‘Managing Public-Private Strategic Alliances’. USA: Information Age Publishing, pp. 1–26.Google Scholar
Roehrich, J, Lewis, M and George, G (2014) Are public-private partnerships a healthy option? A systematic literature review. Social Science & Medicine 113, 110–119.CrossRefGoogle ScholarPubMed
Tiebout, CM (1956) A pure theory of local expenditure. Journal of Political Economy 64, 418–419.CrossRefGoogle Scholar
Toebes, B (2006) The right to health and the privatization of national health systems: a case study of the Netherlands. Health and Human Rights 9, 102–127.CrossRefGoogle ScholarPubMed
Torchia, M, Calabro, A and Morner, M (2015) Public-private partnerships in the health care sector: a systematic review of the literature. Public Management Review 17, 236–261.CrossRefGoogle Scholar
Tu, J, Wang, C and Wu, S (2015) The Internet hospital: an emerging innovation in China. Lancet 3, e445–e446.Google ScholarPubMed
Yip, W and Hsiao, W (2014) Harnessing the privatization of China's fragmented health-care delivery. Lancet 384, 805–818.CrossRefGoogle ScholarPubMed
Yu, W (2007) Hospitals ownership: what can China learn from the US experience? In Lin, S and Song, S (eds), The Revival of Private Enterprise in China. London and New York: Ashgate Publishing, pp. 223–236.Google Scholar