Volume 232

This study compares China and the United States from a patient-centered lens: what a typical resident pay, how predictable those costs are, and how quickly care can be accessed. Using accessible official reports and policy briefs, the analysis focuses on three parts that shape everyday experience-coverage architecture, drug pricing and reimbursement, and provider payment. China combines broad social insurance with provincial risk pooling, centralized drug procurement, and DRG/DIP payment reforms that compress prices and start shifting demand toward primary care. The U.S. keeps a plural structure that supports choice and innovation, but complex benefits and plan churn can raise out-of-pocket risk; recent steps-Medicare drug price negotiation, marketplace subsidies, and moves toward site-neutral payment-aim to reduce volatility. Based on this comparison, the paper proposes three practical actions that ordinary patients can feel: (1) real-time out-of-pocket estimates at prescribing and check-in; (2) clear monthly caps for common chronic medicines; and (3) stronger team-based primary care as a stable “front door.” These options are incremental, fiscally realistic, and measurable through simple indicators such as waiting time, essential-medicine availability, and the share of households facing large medical bills.

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As China enters an advanced stage of population aging, changes in demographic structure present new challenges and opportunities for the insurance industry. Building on a systematic review of literature concerning insurers’ participation in the eldercare industry, this paper uses city-level panel data to empirically test the effect of the degree of aging on insurance expenditures. The results indicate that population aging significantly drives growth in insurance demand, with a particularly pronounced effect on personal insurance products, while property insurance is relatively less affected. This finding suggests that insurers need to place greater emphasis on the development and innovation of eldercare-related products when responding to population aging. At the same time, diversified investment and service models—such as eldercare real estate and community- and home-based care—offer new avenues for insurer development. This study not only enriches the empirical evidence in the field of eldercare finance but also provides a reference for insurers’ strategic planning and policy formulation in the context of population aging.

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