Dr. Jin Ma is the Executive Dean of Shanghai Jiaotong University School of Public Health. In this interview with the China Health Review, conducted by Qi (Harry) Zhang, PhD, (Assistant Professor, Old Dominion University) and Jing Hao, MPH, (Doctoral Candidate, University of Massachusetts, Amherst) in April 2010, Dr. Jin Ma shared his views on China’s Health Care System Reform and ongoing research in Shanghai Jiaotong University School of Public Health.
1. Views and Research on China Health Care System Reform
Harry & Jing: China has officially launched the Health Care System Reform. Do you have any comments?
Dr. Ma: The Health Care System Reform (henceforth ‘the Reform’) is the final product of extensive discussion, consultation and public comments. The Reform addresses major problems and challenges in the current Chinese health care system, is also "provide the whole population with basic medical and health care services”. The main aim of the Reform is to improve the public’s welfare to promote health equity by providing better access to basic health care services through a more efficient health care system. This is an innovative reform reflecting the concepts of scientific development and the people-first principle. The Reform aims to fulfill both the urgent need for patients to gain access to basic health services and the long-term need for a sound health care system. The proposed reform plan of "one goal, four systems, eight pillars" is comprehensive, forward-looking, and plays a positive role in improving China's health system. It is fair to say that the reform plan has a sound scientific foundation. However, we should also acknowledge that health system reform is a challenging issue internationally and cannot be done overnight. As we proceed with the Reform, some deep-rooted problems with vested interests will gradually surface. A relatively long time will be needed to achieve the goals of our Reform.
Harry & Jing: Does the School of Public Health at Shanghai Jiaotong University have related work or research on the current Health Care System Reform?
Dr. Ma: The School participated in a lot of parallel researches from the early days of the Reform, including researches on the public hospital management system, optimization of the health resources allocation, community health development and monitoring and evaluation of the reform.
2. Views on Health Insurance Sustainability in an Aging Society
Harry & Jing: China, especially Shanghai, will gradually become an aging society. What are your thoughts on the sustainability of health insurance?
Dr. Ma: Another highlight of the Reform is to establish universal health insurance coverage. The programs include employment-based health insurance in urban areas that covers all employees working in urban areas and all urban unemployed residents, and the new Rural Cooperative Health Insurance that covers all the rural population. In other words, based on the system stipulated in the Reform, all residents will have some form of health insurance, including the elderly population. From a societal perspective, this universal health insurance system will have the young help the elderly, and the healthy help the sick. However, the funding level for both plans is still relatively low. With the economic growth, we can expect the funding level to increase gradually, broadening the coverage and sustaining the health insurance program in an aging society.
3. Areas of Research in the School
Harry & Jing: What are the highlights of the research projects in the School of Public Health?
Dr. Ma: The main research projects in the School of Public Health, Shanghai Jiaotong University focus on health resources optimization, public hospital management systems and assessment of the effect of the Reform. Here are some specific examples.
· Public hospital scale efficiency study, sponsored by the National Natural Science Foundation of China (70873083), studying the mechanism of cooperation between public hospitals and the primary health care sector that is sponsored by the Ministry of Health, Bureau of Policies and Regulations;
- Study on Countermeasures to ensure public hospitals performance for public interests, funded by the Chinese Ministry of Science and Technology (2007GXS3B049);
- Comparative study of the management system reforms of Chinese government-owned hospitals, funded by the Ministry of Health;
- Study on the management and operation mechanism of state-owned hospitals, funded by the Ministry of Health;
- Further evaluation of the Health Care Reform commissioned by the State Council Leading Office for Health Care Reform; and many more.
The School has also participated in some major international public health policy research in recent years, such as Behavioral Study for the China Youth Tobacco Control, sponsored by Emory University.
4. International Cooperation and Exchange Programs
Harry & Jing: How does the School of Public Health carry out international cooperation and exchange programs? Can you tell us about the educational programs in your school?
Dr. Ma: In recent years, School of Public Health has been actively carrying out international collaborative researches and programs. We co-organized a number of forums with international institutions, including the “China-Australian Health Care Reform Forum” with Monash University, Australia in 2005, the "China-Canada Public Health Forum" with University of Calgary, Canada in 2007, and the “China-US Public Health Forum” with Boston University School of Public Health, U.S. in 2008. In 2010, we co-organized the "International Health Promotion Forum" with countries such as U.S. and Germany. The meeting drew more than 200 attendees from 15 countries and regions. Our school has signed a memorandum for cooperation with Boston University School of Public Health and Tulane School of Public Health and Tropical Medicine. Our school also cooperates with the Master program at Department of Global Health and Population, Harvard School of Public Health, and the Master of Health Management program at Tulane University. Currently, our school has doctoral, masters and undergraduate programs in public health and preventive medicine. Funding for most of our research projects comes from the Chinese government and the China Natural Science Foundation, but there are also some international collaborative projects.
5. Recruitment Opportunities in the School
Harry & Jing: What is the School of Public Health’s policy regarding recruitment of overseas scholars? Do you support national programs such as “Thousands of People Plan” and “Outstanding Youth Program”? Any other opportunities?
Dr. Ma: Our School of Public Health has a relatively short history compared to the rest of the University. To help us achieving international recognition, we are actively recruiting oversea scholars. We recently recruited Dr. Zhi-Jie Zheng from the U.S. National Institutes of Health to be the Dean of the School through the “Thousands of People Plan”. We hope that within the next five years, we will be able to recruit roughly 50 scholars with specialization in public health or preventive medicine.
6. Short-term and Long-term Goals of the School
Harry & Jing: What are the short-term and long-term goals of the School of Public Health? What is the School’s plan to achieve these goals?
Dr. Ma: The short-term goal of the School is to become a first-rate school of public health in China and to provide China with quality public health and preventive medicine professionals. In the long run, we hope to become an internationally recognized institution within 5 to 10 years and eventually become a top school globally in related fields. The School is still mainly focusing on expansion and building up research and teaching capacity. We try to lead or participate in major public health research projects both domestically and internationally and we aim to learn, observe, innovate, improve and grow through international cooperation.
7. Recommendations for CHPAMS
Harry & Jing: The China Health Policy and Management Society (CHPAMS) is a rapidly growing professional community, with the China Health Review (CHR) as its official journal. Do you have any suggestions for CHPAMS and CHR? Are there collaborative opportunities between CHPAMS and the School?
Dr. Ma: I have heard of CHPAMS and its rapid growth from many sources. Sincere congratulations on your achievements! I welcome you to collaborate with scholars, experts and faculty in China, especially with our school concerning China’s health policy and management research. Your participation will help advance the research and practice of health policy and management in China. Finally, my best wishes to the CHPAMS! Thank you!
Qi (Harry) Zhang, PhD, Old Dominion University
Jing Hao, MPH, University of Massachusetts, Amherst
Note: This article was translated from the original transcript in Chinese by Jing Hao, M.S, and proofread by Yinan Peng, MPH, and Zheng (Jane) Li, PhD.