Table 1.

Current healthcare financing arrangements, coverage, and benefit in China

	Three social health insurance schemes			Direct subsidizing of public providers	Medical financial assistance	Free healthcare	Other (private) insurance	Out of pocket (direct payment for care as needed)
	UEBMI	RCMS	URBMI
Beneficiaries	Formal sector workers	Farmers	Urban residents not covered by the UEBMI	All citizens	Poor households with catastrophic health expenses or recognized recipients of China’s social security payments	Public sector employees and special groups such as retired military and Party cadres	Voluntary purchasers of private insurance	Persons not covered by another scheme or having to choose a different health provider (includes many migrant workers)
Population coverage	14.8%	69.5%	9.5%	All citizens	809 million incidents funded in 2011	0.7%	0.3%	5.2% (excludes most migrant workers)
Benefit covered	Outpatient (OP) and inpatient (IP)	Mainly IP, but some counties experiment to cover some care for OPs (e.g., treatment of chronic diseases)	Mainly IP, but some cities experiment to cover some care for OPs (e.g., treatment of chronic diseases)	All services	IP incurring catastrophic cost to individuals	OP and IP	OP and IP
Co-payment arrangement	Practices vary across regions; co-payment occurs for (1) expenses below scheme thresholds and also above ceilings, (2) expenses on high-end or special services excluded from schemes, and (3) the percentage not reimbursable for different services			N.A.	Practices vary cross regions	Very minimal	Varies cross schemes	100%
	OP roughly 30–50%; IP: 10–20%	IP roughly 50–60%	IP roughly 60–70%

Source: Authors’ own compilation; figures from the 2012 China Health Statistics Digest (Ministry of Health 2012b)