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Since the implementation of the New Cooperative Medical Scheme (NCMS) in 2003, this program has experienced rapid growth. Even so, little is known about the association between NCMS expansion and labor force supply among rural residents in China. The purpose of this paper is to examine the effects of the NCMS on labor force supply for rural Chinese populations.

Using data from the China Health and Nutrition Survey (CHNS), a difference-in-differences (DD) approach is employed to estimate the impact of NCMS expansion on labor supply outcomes, including hours of worked in agriculture, off-farm labor force participation, not working, and weeks off due to illness. A number of falsification tests are conducted to identify whether the assumption of common trends of DD analyses is satisfied. The robustness of results is checked through additional estimation, including panel fixed effects and instrumental variable approach.

Results show that the NCMS expansion has a positive effect on the hours of worked in agriculture and off-farm labor force participation, and reduces the likelihood of not working and weeks off due to illness. The effect on hours of agricultural production is larger for male adults, those aged 50 or more, and individuals in low-income families. This study demonstrates the importance of potential health improvements from public health insurance in promoting rural residents’ labor productivity.

Studies concerning the effects of public health insurance on labor supply in developing countries remain limited. The findings of this study provide important insights into how public health insurance programs, like the NCMS, may affect patterns of labor supply among rural residents, and can help policymakers improve health policies aimed to reduce the number of uninsured farmers while maintaining high levels of labor supply, productivity, and health status among the most vulnerable of populations.

The purpose of this paper is to study the effects of introducing a health insurance program in rural China between 2004 and 2006, the New Cooperative Medical Scheme (NCMS).

The authors apply difference in difference and propensity score matching methods (PSM-DID) to a widely used panel dataset, the China Health and Nutrition Survey (CHNS). Findings are robust across several treatment and comparison groups used in previous NCMS studies.

Households who participated in NCMS increased the use of preventive services and western medicine, while lowering the use of traditional Chinese medicine. NCMS also reduced hospital use, out of pocket payments, travel time to healthcare facilities and waiting time to see doctors. The authors estimate that reductions in travel and waiting time saved roughly 52m U.S. dollars in 2006.

Previously divergent findings on health insurance effects may be due to researchers studying health insurance across different healthcare delivery systems. In addition, in estimating how health insurance access affects healthcare costs, the authors should consider economic costs related to the time needed to access health services.

The authors study how health insurance access affects patients' choice of providers and economic costs to accessing health care services, outcomes that have not received much attention previously. The authors depart from previous NCMS studies by comparing several different approaches to identifying treatment and control groups when applying PSM-DID.

Since 1999, China has undergone reform of its healthcare system. City‐based social health insurance (SHI) is the primary form of current health insurance, supplemented by various commercial health insurance programs. The rural new cooperative medical system (NCMS) was introduced in 1993 and extended to cover the whole of rural China in 2003.

The paper developed a theoretical model for consumer demand of medical services and health insurance based on an expected utility framework with a two‐stage decision under uncertainty. The model is then applied to current health insurance systems in China for urban citizens and rural residents separately. Least square and logistic regressions are employed.

The major results are that although the factors driving the decisions on health insurance participation are basically the same for rural and urban citizens, the participation levels are quite different. The major difference is that urban SHI has higher coverage and urban citizens have higher income, resulting in a much larger urban medical expenditure.

The empirical analysis reveals that health insurance programs have played an important role in the healthcare expenditure for urban residents, while the NCMS has not made a significant impact towards increasing the ability of rural residents to seek more medical services, based on data at 2004.

This is the first paper employing a health production theory on China's new urban and rural healthcare programs.

Objectives – Purchasing has been promoted as a key policy instrument to improve health system performance. Despite its widespread adoption, there is little empirical evidence on how it works, the challenges surrounding its implementation, its impact, and the preconditions for it to function effectively, particularly in low- and middle-income settings. The objective of this chapter is to analyze critically the extent to which purchasing could be, and has been used strategically in China and to identify modifications that are needed for purchasing to be effective in assuring that the government's new funding for health care will result in efficient and effective health services.

Methods – We present a conceptual framework for purchasing, which identifies three critical principal–agent relationships in purchasing. We draw on evidence from secondary data, results of other research studies, interviews, and the impact evaluation of a social experiment in rural China that explicitly used purchasing to improve quality and efficiency. This information is used to examine purchasing relationships in urban social health insurance (SHI), the rural medical insurance scheme, and purchasing of public health services.

Findings – To date, use of strategic purchasing is limited in China. Both the urban and the rural health insurance schemes act as passive third-party payers, failing to take advantage of the opportunities to strengthen incentives to improve quality and efficiency. This may be because as government agencies, the extent to which the Ministries of Health and Labor and Social Security can act independently from provider interests, or act in the best interest of the population, is unclear. Other important challenges include ensuring adequate representation of the population's views and preferences and making better use of the leverage provided by purchasing to create appropriate provider incentives, through better integration of financing and improved coordination among purchasers.

Implications for policy – In designing purchasing arrangements, attention needs to be paid to all three principal–agent relationships. Successful purchasing appears to require mechanisms to mobilize and represent community preferences and more strategic contracting with providers. More research is needed to strengthen the evidence on which purchasing arrangements work, which do not work, and under what conditions different purchasing configurations can work most effectively.

The purpose of this paper is to discuss the methodological challenges to evaluating one of the 50 vanguard sites of the new care model (NCM) programme for integrated care in England, and make the case for a modified realist approach to this kind of evaluation.

The paper considers three challenges to evaluating the NCM in this particular vanguard: complexity, strategy and rhetoric. It reflects on how the realist approach negotiates these philosophical challenges to delivering integrated care, in order to provide contextualised accounts of who a programme works for, in what context, and why.

The paper argues that, in the case of this particular vanguard site, the tangible benefit of the realist approach was not in providing a firm epistemological basis for evaluation, but rather in drawing out and articulating the ontological rhetoric of such large-scale transformation programmes. By understanding the work of the NCM less as an objective “system”, and more as a dynamic form of persuasion, aimed at securing the “adherence of minds” (Perelman and Olbrechts-Tyteca, 2008, p. 8) in multiple audiences, the paper suggests that realist evaluation can be used to address both the systematic issues and localised successes the NCMs encountered.

The paper identifies a number of aspects of new models of integrated care for evaluators to consider. It offers ways of negotiating the challenges to conventional outcome-focused evaluation, by drawing attention to the need for contextualised, time-situated and audience-sensitive value of NCMs.

Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

The purpose of this paper is to explore the causality between social security policies and farmland reallocation in rural China.

It quantitatively analyzes the impact of each ongoing social security policy on farmland reallocation based on a data set from the 2011 China Health and Retirement Longitudinal Study (CHARLS, 2011).

The study finds that the inclination of a village farmers’ collective to reallocate farmland due to changes in the village population increased if social security policies do not effectively cover the village because farmers rely primarily on income from farmland to cover their basic living expenses. However, if social security policies provide adequate coverage, then farmers do not rely entirely on on-farm income and the likelihood of farmland reallocation decreases. Furthermore, the effectiveness of social security policies includes not only coverage but also the sufficiency of the security policies provided.

First, the authors use only cross-sectional data in this study, which may result in biased estimation and also limit temporal examination of the impact of social security systems, farmland reallocation and related policy variables. This limitation may be especially important in China because the country is undergoing a rapid socioeconomic transition. However, the research is constrained by the available data. Furthermore, there could be endogeneity problems that are difficult to address, given the current data set. These problems could involve the impacts of village-level economic, natural and social variables, the implementation of related public policies (land development and consolidation, land expropriation, etc.) and other economic variables.

These findings may provide implications for related policy reform in the near future.

These findings may facilitate a recognition and understanding of the causality between social security policies and farmland reallocation in rural China.

The Chinese society has embraced rapid social reforms since the late twentieth century, including educational and healthcare systems. The Chinese Central Government launched an ambitious health reform program in 2009 to improve service quality and provide affordable health services, regardless of individual socio-economic status. Currently, the Chinese social health insurance includes Urban Employee Basic Medical Insurance, Urban Resident Basic Medical Insurance, and New Cooperative Medical Insurance for rural residents. The purpose of this paper is to measure the association between individual education level and China’s social health insurance scheme following the reform.

Using the latest (2011) China Health and Nutrition Survey (CHNS) data and multivariable logistic regression models with cross-sectional design (n=11,960), the odds ratios (OR) and 95% confidence intervals (95% CI) are reported.

The authors found that education is associated with all social health insurance schemes in China after the reform (p<0.001). Residents with higher educational attainments, such as technical school (OR: 6.64, 95% CI: 5.44–8.13) or university and above (OR: 9.86, 95% CI: 8.14–11.96), are associated with UEBMI, compared with lower-educated individuals.

The Chinese Central Government announced a plan to combine all social health insurance schemes by 2020, except UEBMI, a plan with the most comprehensive financial package. Further research is needed to investigate potential disparities after unification. Policy makers should continue to evaluate China’s universal health coverage and social disparity.

This study is the first to investigate the association between residents’ educational attainment and three social health insurance schemes following the 2009 health reform. The authors suggest that educational attainment is still associated with each social health insurance coverage after the ambitious health reform.

A look at co‐operation in United States industry, with firms combining resources to develop, produce and market a product in an attempt to stay competitive whilst cutting the cost of developing new manufacturing technology. Outlines the formation of the National Centre for Manufacturing Sciences. Describes some typical NCMS projects and its education program. Explains Co‐operative Research and Development Agreements by which the government agrees to co‐operate on research with an industry partner by contributing any kind of resource [expertise, equipment, technology) except money. Lists some laboratories involved in robotics research and development and briefly describes their projects.

This study seeks to examine the manifestation and effects of transformational, contingent reward, and active management‐by‐exception leadership across ranks in the Canadian military. It also aims to investigate whether or not the relationships between perceived leadership behaviors and effective leadership outcomes are moderated by hierarchical level and followers' expectations.

A total of 704 military officers and enlisted members rated their leaders' behaviors and the behaviors they expect of their leaders.

Frequency of transformational leadership behaviors increased with rank, but frequencies of perceived and expected contingent reward and active management‐by‐exception leadership behaviors did not. Transformational and contingent reward leadership effects were not moderated by rank or by followers' expectations. The effects of perceived active management‐by‐exception leadership were moderated by followers' expectations.

When followers do not expect active management‐by‐exception from their supervisors, based on their own implicit beliefs about the types of behaviors their leaders should be exhibiting, but they are subjected to it, their job satisfaction and their attitudes toward their supervisors may be negatively affected.

Transformational leadership is prevalent, expected, and effective at all hierarchical levels. Because of their positive impact on followers' job satisfaction and their attitudes toward their supervisors, the Canadian military should continue to encourage transformational leadership and contingent reward leadership behaviors at all hierarchical levels.

The study highlights the potential importance of congruence between the expectations followers have of their leaders and followers' perceptions of their leaders' actual behaviors.