context: Policies have been issued since 2013 to promote the integration of health care and aged care, which experts believe is vital for China’s growing elderly population. ‘Integrated care’, as it is called, got its latest boost in May 2019 when NHC and three other agencies announced the streamlining of registration and licensing for integrated care agencies. However, implementation still faces multiple obstacles.
China Elderly Care Weekly observes that integrated care in China is facing problems. On the supply side, integrated care providers suffer from high operational costs and lack of human resources when providing low-quality services. On the demand side, many can’t afford the care, and the health insurance system is under pressure with the scale of effective demand low.
The government has preferred expanding investment over integrating health care and aged care providers’ services. While the former is easier and more visible, it also requires lots of funding for very few facilities. The government has also emphasised infrastructure, while neglecting services such as staff training.
The supervision of ongoing projects has been neglected, resulting in market chaos and significant mismatch between supply and demand. There is a serious over-supply of both high-end and poorly-furnished elder care facilities, but highly sought-after mid-range facilities are lacking.
Currently only medical expenses are reimbursed, but aged care expenses are not, and neither basic medical insurance nor basic pensions can be used toward integrated care expenses. Elders’ inability to pay has deterred integrated care demand. Wan Rentao 万仁涛 Houpu Aged Care Consultancy senior partner says long-term care insurance should provide financial assistance to elders who struggle with activities of daily living (ADLs).
There is also a lack of coordination between government agencies. No single central agency is responsible for integrated care, and notices are almost always released jointly by several. At the local level, even more agencies are involved. Though policies are in place, differing opinions from different agencies make implementation difficult.