China

In general, health insurance is publicly provided and financed by local governments. It varies with local-area risk pooling: urban employer-based, urban resident basic, and a rural cooperative medical scheme.

Urban employer-based medical insurance is funded mainly from payroll taxes and participation is mandatory for employees in urban areas. The insured population was around 283 million in 2014. Urban resident basic medical insurance is voluntary at the household level, and covered 314.5 million self-employed individuals, children, students, and young adults in 2014. The rural cooperative medical scheme is also voluntary at the household level and cover a rural population of 736 million (which is a 98.9% coverage rate of rural residents). Both urban resident basic insurance and the rural cooperative medical scheme are mainly financed by government, with minimum individual premium contributions.

Publicly-financed healthcare has reached near-universal coverage – more than 95% of citizens, and it serves as primary coverage source.

On the other hand, private health insurance is mainly provided by for-profit insurance companies as a complement to public healthcare to cover cost-sharing and gaps, as well as to provide better health care quality and/or higher reimbursements to providers. The growth of this market has been rapid, as the Chinese government is encouraging its development.