March 14th, 2008, riots happened in Tibet. Many harmless people were killed. Buildings and cars were burnt. Many of Chinese consulates were destoried by exiled Tibets... I made this video to record this riots and expose the truth.
Sunday, March 23, 2008
Tibet
I did my best to avoid bias in this video. I just want to show some fact and let my audiences to tell the truth themselves.
A policy reform topic beyond rural China’s health system
In the 1970s, China was the first large nation in the world to develop a nationwide rural health insurance system. At that time, China emphasized prevention and public health for rural health care based on community financing schemes called the Rural Cooperative Medical System (RCMS), making essential drugs and basic health care widely available, and creating an organized three-tiered health care delivery system of village health posts, township health centers and county hospitals From that time, China’s rural health system is characterized by a 3-tier structure – county health facilities (Including county hospital, disease prevention station, maternal and child health center), township health centers, and village health posts. Under the RCMS, the financing of health care relied on a pre-payment plan. Most villages funded their RCMS from three sources:(1) premiums-depending on the plan’s benefit structure and the local community’s economic status, 0.5 to 2 percent of a peasant family’s annual income was paid to the Fund; (2) the collective welfare fund—each village contributed a certain portion of its income from collective agricultural production or rural enterprises into a welfare fund, according to State guidelines; (3) subsidies from higher-level government structures. In most cases, this subsidy was used to compensate health workers and purchase medical equipment. By the mid-1970s, about 90 percent of China’s rural villages, called “communes” at the time, were covered by RCMS schemes. This community financing and organization model of health care was believed by many to have contributed significantly to China’s success in accomplishing its first ‘health care revolution’
Since the 1980s, China has moved away from central planning towards a market economy, a trend that is also reflected in the health system. Along with growing commercialization within the economic sector, access to health care has been increasingly dictated by ability to pay. In rural areas, the transition from agricultural collectives to what is termed the household responsibility system weakened the financial base of the cooperative medical system. The RCMS schemes collapsed in the majority of rural communities. In 1993, insurance coverage for rural residents had fallen to 12.8%. By 1998, only 9.5% of the rural population was insured. This decrease in insurance cover for the rural population has taken place at a time when medical costs have escalated.
Internationally, as a country’s income increases, the share of that country’s total health expenditure accounted for by government also tends to increase. But in China, a country with very rapid income growth, while total health spending as a percentage of GDP increased from 3.2 percent in 1980 to 4.8 percent in 1998, the government share of that total decreased from 36.4 percent to 15.5 percent. Over the same period, the private spending share increased from 23.2% to 57.8%. Since the collapse of the once successful RCMS in the early 1980s, many rural residents, especially the poor, have faced severe problems. User charges and high direct costs now effectively block access for the many people who lack sufficient income to purchase basic healthcare when they need it. Moreover, medical expenses have also caused financial catastrophe for many rural families. According to the MOH’s national health services surveys, nearly 80% of the rural residents do not have any insurance coverage today, although overall insurance coverage improved somewhat (mainly due to an increasing percentage of people buying private insurance) over the 10-year period between 1993 and 2003.
Lack of insurance coverage coupled with escalating medical costs causes serious access and impoverishment problems for Chinese rural residents. According to the China 2003 National Health Services Survey, 30% of the rural patients who were recommended hospital admissions by the doctors refused to be hospitalized. The majority of those who had forgone hospitalization (70%) cited lack of financial means as the major reason for their decision. Even among those who were hospitalized, 43% discharged themselves against medical advice. When officially designated rural “poor households” were asked to identify the major reasons for their impoverishment, the most frequently cited reason was disease and injury.
Why has a rural health insurance system not emerged to meet the needs illustrated above? Prof. Liu (2004) analyzed some major factors affecting the development of rural health insurance system in China. These factors include lack of ability to pay by low-income families, adverse selection among those who are able to pay, and lack of the organizational capacities needed to run such schemes. But by far the most important issue is the little investment sponsored by central and local government and the weak role they played (see Table 3). This main problem will directly influence on both demand-side and supply-side of rural China’s health system.
Lack of the corresponding subsidy of government, insofar as a health insurance system is not compulsory, people’s ability to pay and willingness to participate/contribute is vital for sustaining the system. Therefore, it is not surprising that higher-income regions in China have higher insurance coverage than lower-income regions (Wang 2001). Aside from ability to pay, there are other factors affecting people’s willingness to participate in voluntary risk sharing schemes.
Supply-side issues: Financing takes the form of regular budget allocations from the county and township governments to cover some basic salaries of the staff and capital development and depreciation. The money from these government budgets, however, only accounts for less than 30% of the total income of the county and township health facilities. The rest of their income comes from services fees these facilities charge and from the proceeds of drug sales (the dominant source of revenue). Furthermore, since the majority of village health posts are private practitioners, they receive almost no budget allocations from the governments, and thus rely totally on revenues for their income.
According to World Health Organization annual report of 2005, a health system is a means to an end. It converts resources into outputs, which produce desirable outcomes. These outcomes (or goals of health systems) at least include: Health status; Financial risk protection, and Consumer satisfaction (both levels and fair distribution).
For the purpose of this analysis, a rural health system in China can be defined to include the people, organizations, and institutions that:
1.Deliver health care, including treatment, prevention, and promotion
2.Finance and pay for health care • produce or provide the specialized inputs to health care
3.Organize, control, and regulate those that do the above.
Therefore, a health system can be described by a web of inter-relationships among the five major stake-holders: consumers (patients as well as general public), resource producers (producing material as well as human resources such as pharmaceutical manufacturers and medical schools), service providers (e.g. hospitals for providing inpatient care and schools for providing health education), payers (e.g. government, employers, insurance companies, and of course households), organizers and regulators (e.g. government agencies and professional associations). Without efforts to all the goals above, reform is just required by circumstances.
Since the early 1980s, the rural health care system has undergone far-reaching marketization reforms in tandem with China’s overall economic system. The major motive for market-oriented reforms in the health care sector lies in the government’s attempt to use market function to deal with the problem of public health financing and control of health care costs. While pursuing financial decentralization, governments at a higher level have often delegated the responsibility of health care financing to the governments at a lower level, but the latter, however, are often in financial difficulties that result in the transfer of the responsibility further down to health care institutions. As a result of financial decentralization, the three-tier health service network in rural China has been challenged by the decline of public investment. The share of public health expenditure in the total financial expenditure declined from 2.49% in 1980 to 1.71% in 2000. The cooperative health care system virtually disappeared following the collapse of the People’s Commune System, and the overwhelming majority of village health clinics were privatized.
The New CMS differs from the old CMS in several important respects. Contributions from households—starting at 10 RMB per person, and to be paid on a voluntary basis—will be supplemented by a subsidy of 10 RMB or more from local government and a 10 RMB matching subsidy from central government in the case of households living in the poorer central and western provinces. The major difficulties may be encountered include financial strain on the local government budget, high administrative costs in collection, and lack of administrative capacity.
The New CMS differs from the old CMS in several important respects. Contributions from households—starting at 10 RMB per person, and to be paid on a voluntary basis—will be supplemented by a subsidy of 10 RMB or more from local government and a 10 RMB matching subsidy from central government in the case of households living in the poorer central and western provinces. The major difficulties may be encountered include financial strain on the local government budget, high administrative costs in collection, and lack of administrative capacity.
The strong recommendation that should be made from this policy comparison is that Chinese health reform should insist the “20 Yuan” path and begin to set up a more constructive rural health system. The Government subsidy for the New CMS is a significant step in the history of rural health development in China. It shows the commitment the Government has made to improving the health of its rural population and to reducing their financial health burden. It will also significantly influence the rural health care delivery system, patients' health treatment-seeking behavior and the rural-to-urban population transition.
But going down the path, the New CMS will face complex technical problems. First, a realistic benefits package must be formulated. If the services offered to farmers do not meet their needs, they will soon choose not to participate in the program. On the other side, while protecting farmers from poverty caused by catastrophic disease is an admirable goal, it is most likely counter-productive to set such an ideal as the predominant goal, invariably at the expense of other needs. Health care is a life-long process, and resources might be more wisely spent on more effective preventive efforts like insuring that New CMS subscribers receive immunizations and have access to early disease detection programs and regular checkups, or are convinced to stop smoking.
Another concern is that the New CMS will need a large but dynamic management to deliver fairly priced services to its subscribers. The bureaucracy must be large because of the sheer number of subscribers it needs to survive, and dynamic because it must respond to the demands of those subscribers or else they will decide not to participate. The Government must expand its provision of the important public good of management expertise and development if it hopes for a successful program. And the role of Government as supervisor, monitor and enforcer of standards is the only hope for quality healthcare. Without this Government regulatory and enforcement role, good management, improved funding and even the best efforts of local officials are not likely to suffice.
Since the 1980s, China has moved away from central planning towards a market economy, a trend that is also reflected in the health system. Along with growing commercialization within the economic sector, access to health care has been increasingly dictated by ability to pay. In rural areas, the transition from agricultural collectives to what is termed the household responsibility system weakened the financial base of the cooperative medical system. The RCMS schemes collapsed in the majority of rural communities. In 1993, insurance coverage for rural residents had fallen to 12.8%. By 1998, only 9.5% of the rural population was insured. This decrease in insurance cover for the rural population has taken place at a time when medical costs have escalated.
Internationally, as a country’s income increases, the share of that country’s total health expenditure accounted for by government also tends to increase. But in China, a country with very rapid income growth, while total health spending as a percentage of GDP increased from 3.2 percent in 1980 to 4.8 percent in 1998, the government share of that total decreased from 36.4 percent to 15.5 percent. Over the same period, the private spending share increased from 23.2% to 57.8%. Since the collapse of the once successful RCMS in the early 1980s, many rural residents, especially the poor, have faced severe problems. User charges and high direct costs now effectively block access for the many people who lack sufficient income to purchase basic healthcare when they need it. Moreover, medical expenses have also caused financial catastrophe for many rural families. According to the MOH’s national health services surveys, nearly 80% of the rural residents do not have any insurance coverage today, although overall insurance coverage improved somewhat (mainly due to an increasing percentage of people buying private insurance) over the 10-year period between 1993 and 2003.
Lack of insurance coverage coupled with escalating medical costs causes serious access and impoverishment problems for Chinese rural residents. According to the China 2003 National Health Services Survey, 30% of the rural patients who were recommended hospital admissions by the doctors refused to be hospitalized. The majority of those who had forgone hospitalization (70%) cited lack of financial means as the major reason for their decision. Even among those who were hospitalized, 43% discharged themselves against medical advice. When officially designated rural “poor households” were asked to identify the major reasons for their impoverishment, the most frequently cited reason was disease and injury.
Why has a rural health insurance system not emerged to meet the needs illustrated above? Prof. Liu (2004) analyzed some major factors affecting the development of rural health insurance system in China. These factors include lack of ability to pay by low-income families, adverse selection among those who are able to pay, and lack of the organizational capacities needed to run such schemes. But by far the most important issue is the little investment sponsored by central and local government and the weak role they played (see Table 3). This main problem will directly influence on both demand-side and supply-side of rural China’s health system.
Lack of the corresponding subsidy of government, insofar as a health insurance system is not compulsory, people’s ability to pay and willingness to participate/contribute is vital for sustaining the system. Therefore, it is not surprising that higher-income regions in China have higher insurance coverage than lower-income regions (Wang 2001). Aside from ability to pay, there are other factors affecting people’s willingness to participate in voluntary risk sharing schemes.
Supply-side issues: Financing takes the form of regular budget allocations from the county and township governments to cover some basic salaries of the staff and capital development and depreciation. The money from these government budgets, however, only accounts for less than 30% of the total income of the county and township health facilities. The rest of their income comes from services fees these facilities charge and from the proceeds of drug sales (the dominant source of revenue). Furthermore, since the majority of village health posts are private practitioners, they receive almost no budget allocations from the governments, and thus rely totally on revenues for their income.
According to World Health Organization annual report of 2005, a health system is a means to an end. It converts resources into outputs, which produce desirable outcomes. These outcomes (or goals of health systems) at least include: Health status; Financial risk protection, and Consumer satisfaction (both levels and fair distribution).
For the purpose of this analysis, a rural health system in China can be defined to include the people, organizations, and institutions that:
1.Deliver health care, including treatment, prevention, and promotion
2.Finance and pay for health care • produce or provide the specialized inputs to health care
3.Organize, control, and regulate those that do the above.
Therefore, a health system can be described by a web of inter-relationships among the five major stake-holders: consumers (patients as well as general public), resource producers (producing material as well as human resources such as pharmaceutical manufacturers and medical schools), service providers (e.g. hospitals for providing inpatient care and schools for providing health education), payers (e.g. government, employers, insurance companies, and of course households), organizers and regulators (e.g. government agencies and professional associations). Without efforts to all the goals above, reform is just required by circumstances.
Since the early 1980s, the rural health care system has undergone far-reaching marketization reforms in tandem with China’s overall economic system. The major motive for market-oriented reforms in the health care sector lies in the government’s attempt to use market function to deal with the problem of public health financing and control of health care costs. While pursuing financial decentralization, governments at a higher level have often delegated the responsibility of health care financing to the governments at a lower level, but the latter, however, are often in financial difficulties that result in the transfer of the responsibility further down to health care institutions. As a result of financial decentralization, the three-tier health service network in rural China has been challenged by the decline of public investment. The share of public health expenditure in the total financial expenditure declined from 2.49% in 1980 to 1.71% in 2000. The cooperative health care system virtually disappeared following the collapse of the People’s Commune System, and the overwhelming majority of village health clinics were privatized.
The New CMS differs from the old CMS in several important respects. Contributions from households—starting at 10 RMB per person, and to be paid on a voluntary basis—will be supplemented by a subsidy of 10 RMB or more from local government and a 10 RMB matching subsidy from central government in the case of households living in the poorer central and western provinces. The major difficulties may be encountered include financial strain on the local government budget, high administrative costs in collection, and lack of administrative capacity.
The New CMS differs from the old CMS in several important respects. Contributions from households—starting at 10 RMB per person, and to be paid on a voluntary basis—will be supplemented by a subsidy of 10 RMB or more from local government and a 10 RMB matching subsidy from central government in the case of households living in the poorer central and western provinces. The major difficulties may be encountered include financial strain on the local government budget, high administrative costs in collection, and lack of administrative capacity.
The strong recommendation that should be made from this policy comparison is that Chinese health reform should insist the “20 Yuan” path and begin to set up a more constructive rural health system. The Government subsidy for the New CMS is a significant step in the history of rural health development in China. It shows the commitment the Government has made to improving the health of its rural population and to reducing their financial health burden. It will also significantly influence the rural health care delivery system, patients' health treatment-seeking behavior and the rural-to-urban population transition.
But going down the path, the New CMS will face complex technical problems. First, a realistic benefits package must be formulated. If the services offered to farmers do not meet their needs, they will soon choose not to participate in the program. On the other side, while protecting farmers from poverty caused by catastrophic disease is an admirable goal, it is most likely counter-productive to set such an ideal as the predominant goal, invariably at the expense of other needs. Health care is a life-long process, and resources might be more wisely spent on more effective preventive efforts like insuring that New CMS subscribers receive immunizations and have access to early disease detection programs and regular checkups, or are convinced to stop smoking.
Another concern is that the New CMS will need a large but dynamic management to deliver fairly priced services to its subscribers. The bureaucracy must be large because of the sheer number of subscribers it needs to survive, and dynamic because it must respond to the demands of those subscribers or else they will decide not to participate. The Government must expand its provision of the important public good of management expertise and development if it hopes for a successful program. And the role of Government as supervisor, monitor and enforcer of standards is the only hope for quality healthcare. Without this Government regulatory and enforcement role, good management, improved funding and even the best efforts of local officials are not likely to suffice.
Saturday, March 22, 2008
Crisis Management for Martha Stewart
Martha Stewart is the creator and namesake of Martha Stewart Living Omnimedia Inc. (MSO) She was indicted and sentenced for lying about ImClone stock sale which was based on insider information she got from Samuel Waksal, the founder and former CEO of ImClone System Inc. After this seemly innocent deal, MSO stock began a steady fall. Ms .Stewart lost her credibility, her position as the chairman and Chief Executive officer of MSO, her splendid future as a director of a
The situation could be better if Ms. Stewart applied crisis management when she dealt with this scandal.
From the perspectives of Public relations, time is very important when crisis happens. “A quick response is an active response because it tries to fill the vacuum forms”. Ms. Steward released her statement about this scandal on June 12th. But the news was breaking out in the early June. Her slow reaction generated enough time for public to think about whether she got insider information or not. Oppositely, her public relation people should be very sensitive to notice what happened and act properly once the scandal broke out. If I am her PR, once I got to know what was going on, I will tell shareholders of MSO and media that we are investigating into this trade devotedly. We faithfully trust the law and will be responsible to the fair conclusion.
Besides Ms. Martha herself, there were several representatives make public announcements for her, such as her spokewoman, Susan Magrino and assistant Ann Armstrong. Furthermore, they gave public entirely different information. Ms. Stewart defended herself being innocent in this scandal confidently. Her sporkwoman did it as well. When the truth was coming out, Ms. Stewart’s assistant testified that Stewart personally altered the log of a message Bacanovic left on the day she told her ImClone stock. What they did is a blunder accord to crisis management theories. Consistency means that various messages sent by an organization are free of contradictions.Inconsistency erodes the believability of a message. The contradicted messages didn’t provide Ms. Stewart is innocent but disclosed her dishonesty and guilty. If I was Ms. Stewart, I wouldn’t assert Ms. Martha got insider information or not before I get enough evidence to support my statement.
I think the most controversial recommendation, openness, in Ms. Stewart’s is crucial. Ms. Stewart didn’t make openness in the whole process. What she did is try to conceal the truth. She always denied she got the insider information. Meanwhile, Ms. Stewart and her associates sold $79 million worth of MSO stock. These trades made some shareholders became disgruntled because they were made prior to information about Stewart’s investigation being made public. I think she could deal with this problem better is she fully admit she got the insider information. As one of 46 who got ImClone failure news, selling her share is reasonable. Ms. Stewart couldn’t refuse others to give her information. Gotten this message, conservative shareholders would definitely get rid of stocks expected devaluated. If Ms. Stewart can frankly admit her trade based on the insider information and be responsible for this results. From perspectives of PR, full apology is very high acceptance and corrective action is high acceptance. If I was her PR, I would help her to analysis the crisis and encourage her to admit what she heard and what she did. Even though frankness may be damaging, for a long term, it will help to reinforce a positive, honest, responsible American idol. Furthermore, I will persuade her to correct what she did. In this situation, I think the best correction is making up in other ways. For example, donate the unlawful income to charity. Doing this will clarify that Ms. Stewart is not a greedy woman; she makes mistakes involuntarily and tries her best to correct them.
Another detail needed to be mention is Ms. Stewart’s emotion control. In the whole process, Ms. Stewart’s action and talk is improper. She used adjectives such as ridiculous to blame literally everyone from the media to her brokerage to public. She canceled future segments on the show where she was asked a question about ImClone by the anchor. She always emphasized good thinks she did but avoid the unlawful trade. Even after she got the final judgment, she tired to testify she is a good person by analogy herself with
If Ms. Stewart knows how to manage crisis or apply what I suggested above, I believe the final situation will be more favorable to her.
Wednesday, March 19, 2008
How can Tibet be flourishing
As a people who was born and raised in China, when I heard people protest to free Tibet, I cannot help wondering what kind of freedom these people are asking for. Do these people really understand what freedom is? Do they really know what situation is best for Tibetans?
First of all, I have to say, Tibet was and is one part of China. Even though Chiang Kai-Shek gave away Outer Mongolia, he still admitted Tibet is one part of China. The government of People's Republic of China never and won't ever give up Tibet. This is a fact and never will be changed.
July 1st 2006, Qing Zhang railroad launched. The great railroad changed Tibetans' lives. Tourism industry help Tibet get billions revenue annually. Developing economic situation helps Tibetans approach better living standard and happiness. If happiness and better living standards don't represent freedom, so what is it?
Let us trace back to when Tibet under Dalai Lama’s reign. 80% or more resources were controlled by landlords and monks who are just less than 20% population. Tibet is one of the few places controlled by religion. People were hunted rudely under such tyranny. Their skin was peeled, their eyes were scratched, and their arms were stumped. No Tibetan would like to go back to danger. They have no reason to refuse better lives.
In a word, Tibet being a part of China is unchangeable truth. Only as one part of China, Tibet develops smoothly and quickly.
First of all, I have to say, Tibet was and is one part of China. Even though Chiang Kai-Shek gave away Outer Mongolia, he still admitted Tibet is one part of China. The government of People's Republic of China never and won't ever give up Tibet. This is a fact and never will be changed.
July 1st 2006, Qing Zhang railroad launched. The great railroad changed Tibetans' lives. Tourism industry help Tibet get billions revenue annually. Developing economic situation helps Tibetans approach better living standard and happiness. If happiness and better living standards don't represent freedom, so what is it?
Let us trace back to when Tibet under Dalai Lama’s reign. 80% or more resources were controlled by landlords and monks who are just less than 20% population. Tibet is one of the few places controlled by religion. People were hunted rudely under such tyranny. Their skin was peeled, their eyes were scratched, and their arms were stumped. No Tibetan would like to go back to danger. They have no reason to refuse better lives.
In a word, Tibet being a part of China is unchangeable truth. Only as one part of China, Tibet develops smoothly and quickly.
Wednesday, March 12, 2008
Chinese Americans in American President Election
2008/2/13
Clinton and Obama sent open letters to celebrate Chinese New Year separately last week. It is obvious that both of their intention is getting Chinese Americans’ support. There are about three million Chinese Americans. They can affect not only the competition between Clinton and Obama in the Democratic primaries, but also the whole American President campaign.
Until Feb 12th, Obama got 1181 delegates and Hillary got 1173. It is worth mentioning because this is the first time Obama surpassed Clinton in the number of delegates since the Iowa caucuses. According to Democratic primaries rule, in primaries, candidate has to get at least 2025 delegates to clinch the Democratic nomination. Obama and Clinton have been devotedly fighting for each delegate. Naturally, the community of about three million of Chinese Americans is an important part of their targets.
Compared with Republican, more Chinese Americans support Democratic. The most important reason is that Democratics give more protection on minorities’ interests and claim culture diversity. On the other hand, Republicans show more conservative toward immigrations. That is why in 2000 President Election most Chinese Americans voted for Gore.
It is easy to find that Chinese Americans support Clinton more in California Democratic primaries. Obama never stop his active pursuit of Asians’ supports. He sent his Chinese New Year greeting letter out even one day earlier than Clinton did. His sincerity helped him win considerable supports from Chinese American community.
There are eleven million Asian Americans and over one fourth of them are Chinese. It is an important political power and cannot be ignored. Chinese Americans will play a more important role on American politics. It is not only due to the big population but also because of the more and more important role of China in the world. I believe that Chinese Americans will affect American politics more along with the development of China.
Subscribe to:
Posts (Atom)