Health Wonk Review: Health Insurance in China over the Past 50 Years; A Review of The Autistic Brain; Stay Calm, Obamacare is On Track

The newest edition of HealthWonk Review, a round-up of some of the very best recent healthcare posts, is now online.
Colorado Health Insurance Insider’s Louise Norris hosts this mid-summer edition of the review. She offers summaries of intriguing posts, along with evenhanded, insightful commentary. Both will help you decide which posts you want to read.
Many of her reviews whetted my interest. But here I want to call attention to just two entries covering topics that we don’t often read about on Healthcare blogs, as well a reassuring sane post summing up what Washington insiders say about the state of Obamacare. It will be a bumpy ride, but it’s heading into the station.

A History of China’s Health Care System

Norris reports that on :“The Healthcare Economist,  Jason Shafrin, brings us a great summary of health insurance in China over the past half century. Until the end of the 1970s, there were three main health insurance systems in China that covered nearly everyone.
“But the wheels started to come off after that; by 1998 almost half of the urban population had no health insurance, and by 2003, 95% of the rural population in China was uninsured. “
Shafrin explains that a shift to “fee for service” health care seems to have exacerbated the problem: “Some have claimed that the stark increases in health-care are due to provider profit-seeking behavior in China’s fee-for-service system. . .
“This price structure that was originally intended to cross-subsidize the delivery of basic interventions creates perverse incentives for providers to supply sophisticated care wherever possible, by shifting demand from low-margin basic services to high-margin high-tech diagnostic services and drugs.”
Does this sound familiar?
The good news is that China, like the U.S., has set out to reform its enormous health care system.For details, see Shafrin’s post. .
As Norris observes: “While plenty of progress has been made there is still a long way to go.”
She could have been talking about either country.
Norris also spotlights Jared Rhoads’ review of The Autistic Brain by Temple Grandin. “If you’re interested in autism,” Norris writes, “Jared’s summary [suggests] that this book is a good place to start learning more. I’m adding it to my list of books to read, so thanks for the tip Jared!”
Here’s just a snippet from Rhoads’ review: “Gradin and coauthor Richard Panek trace some of the clinical history of the condition, explain what can and cannot be gained from techniques like neuroimaging, and share what they believe are some good child-rearing strategies for parents with autistic children. . . .

One of the more interesting sections of the books deals with the changing definitions used in the Diagnostic Manual of Mental Disorders (DSM) over the years. She shows how subtle changes in the way that autism is defined clinically can lead to immense growth in the number of people diagnosed—and thereafter labeled—autistic. Gradin reviews this history with an appropriate amount of skepticism and resistance, in favor of refining diagnostic criteria based on growing scientific knowledge but wanting to avoid perpetuating ‘label-lock’ and gratuitous diagnoses.”

I have written about the over-diagnosis of autism; once a child is mis-labeled, it’s all but impossible to undo the damage. 

 Finally, Norris highlights Linda Bergthold’s  “straight-forward and factual review” of the state of Obamacare  on  Bergthold acknowledges that “It’s a sour and angry time in Washington D.C” where conservatives continue to try to persuade us that  the Affordable Care Act is unraveling.  But she advises,, “Keep Calm. The end (of the wait) for Obamacare is near.”

“After discussions with Washington insiders and key health policy experts this week, I’ve concluded that the consensus seems to be the following:

–The Employer mandate won’t be overturned;

–There will be No delay – or repeal – of the individual mandate; and

— The health insurance marketplaces are still on track.”



2 thoughts on “Health Wonk Review: Health Insurance in China over the Past 50 Years; A Review of The Autistic Brain; Stay Calm, Obamacare is On Track

  1. Maggie:

    I will be surprised if the China healthcare reform gets legs. One of the biggest globalization enticements of going to China is the lack of Overhead or that Overhead which is customary or legislated in the US. My own experience with the Chinese, Thais, etc when working there and with them was healthcare consisted of a nurse or doctor on staff. Implementing a healthcare system is gonna cost money and reduce their competiveness.

    Of course, stranger things have happened. A side note, I really need to understand what you stated in your one article since I am taking on the local establishment who are anti-PPACA. I would appreciate your input Maggie in email form.

    Best of regards,


    • Bill–

      I havent’ worked in China- so I don’t have your direct experience.

      But I do know businessmen and people who manage money there.

      It’s an enormous, complicated country. What’s happening in one region isn’t necessarily happening in another.

      The leadership is, I think, quite intelligent. But they have way too much on their plate–
      huge environmental problems, an enormous population that must be fed and employed–or there will be civil unrest. And in China, that doesn’t mean just 3000 people getting together and marching. It means revolution.. .

      My guess, based on the post, is that there are pockets of improvement (or at least the beginning of improvement) in China’s health care system.

      I’ll look at your e-mail and try to answer your question.