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From Health Affairs:


Shanghai's Health Care Reforms Explained


Bethesda, MD -- "I think health reform is not like what some say--a matter of two, three, or four years of efforts, and you get a brand-new health system. So I do not look for one-shot earthshaking effects. Instead, I focus on whether the policies we put in place will be sustainable," says former Shanghai Vice Mayor Shen Xiaoming, in an interview being released today as a Web First by Health Affairs. Shanghai, China's largest city, offers its residents the country's most advanced health care system. Through a powerful health information technology system, there have been great strides--though challenges remain. Shen, who served as vice mayor from January 2008 through July 2013, spoke to Tsung-Mei Cheng in Shanghai on June 18, 2013.


Explaining Shanghai's Health Care Reforms, Successes, And Challenges

By Tsung-Mei Cheng


Cheng is Policy Research Analyst at the Woodrow Wilson School of Public and International Affairs at Princeton University.


The study will also appear in the December issue of Health Affairs.

Some interview highlights:


  • Since July all Shanghai doctors can see their patients' records from any hospital.

  • In 2008 health spending was growing at a rate of 22-25 percent a year. After global budgeting, capitation, and other payment reforms, health spending has been reduced to 8-9 percent a year.

  • Although global budgeting has helped reduce health spending, Shen sees it as a stopgap measure that will pave the way for the development of an integrated health system.

  • To alleviate hospital crowding, Shanghai built tertiary hospitals in the outer city rings, where 60 percent of residents live. Some doctors, underused in the "mother hospitals," were transferred to these new facilities.

"Luckily, it is relatively easier to get things done in Shanghai than in the United Shanghai the government is in charge of health care, whereas in the United States the private sector plays a large role...[W]e get things done faster...because more or less, I am the chairman of the board of all the hospitals in Shanghai," Shen concluded.

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.