Kolleen Rask

The Transformation of China’s Health Care System and Accounting Methods: Current Reforms and Developments

This paper is a case study of China’s recent reforms in hospital accounting. We analyze the Chinese health care system in transition to highlight the changing role and nature of accounting services before and after the recent reforms. Prior to reforms, the accounting system provided data solely for government central planning purposes. Reforms were supposed to decentralize hospital decision making, thus signaling a need for a new accounting system that would provide information to managers and resource providers. However, the government continues to maintain control by fixing basic medical service prices at levels below cost while allowing profit margins for pharmaceutical sales and other advanced medical services. This schizophrenic policy of quasi-decentralization/macro-control has resulted in an accounting information system that serves neither the need of managers nor external resource providers. In January 1999, major reforms were instituted in China’s hospital accounting system, creating a more streamlined structure. The legacy of the command economy, however, remains clearly evident in the areas of revenue control and state subsidies. Hospital accounting in China is therefore subject to the ongoing evolution of the government’s health care policy.

The Impact of Regime Type on Food Consumption in Low Income Countries

Abstract Competing studies use food consumption to measure the impact of political regime on the welfare of the poor. Democracies may outperform autocracies by using growth to hide redistribution, improving caloric consumption and currying favor. Alternatively, autocracies may have greater incentives to lower food prices to quell urban unrest. We test these competing theories using a more detailed, continuous, nuanced measure of food consumption quality – cereal equivalent values. We find evidence to support the second hypothesis, that autocracies outperform democracies at low incomes. For higher incomes, democracies perform significantly better. Segregated by growth, autocracies again outperform democracies at low incomes.