China started comprehensive health system reforms in 2009. An important goal of China’s health system reforms was to achieve universal health coverage through building a social health insurance system. Universal health coverage means that all individuals and communities should get the quality health services they need without incurring financial hardship. It has three dimensions: population coverage, covering all individuals and communities; service coverage, reflecting the comprehensiveness of the services that are covered; and cost coverage, the extent of protection against the direct costs of care.
The authors examine China’s progress in enhancing financial protection of social health insurance and identify the main gaps that need to be filled to fully achieve universal health coverage. They find that, after a decade of comprehensive health system reforms, China has greatly increased access to and use of health services, but needs to further enhance financial protection for poor populations to fully achieve its commitment to universal health coverage.
This article is part of a BMJ collection with Peking University that analyzes the achievements and challenges of the 2009 health system reforms and outlines next steps in improving China's health.