III. Health and Medical Care for the Aged
Improving medical care and service for the aged and enhancing their health
are an important part of the efforts for the overall improvement of the people's
health and quality of life in an ageing society. The Chinese government pays
great attention to medical care for senior citizens in both urban and rural
areas by improving medical and health services for them so as to meet their
basic medical needs and improve their mental and physical health.
Strengthening Medical Care for the Aged in Urban and Rural Areas
has established a basic medical insurance system which combines the unified
planning program with individual accounts for urban employees. Under this
system, retirees do not have to pay the basic insurance premiums, and they are
given appropriate consideration in the ratio of medical costs paid between what
is put into their individual accounts by their former employers and the part
they have to pay personally. The general practice now is that large amounts for
the medical costs for elderly people's common and chronic diseases are covered
by the funds under the unified planning program, thus reducing the percentage
paid by the individual retirees. By the end of 2005, retirees covered by the
basic medical insurance in China had reached 37.61 million.
The state has taken supplementary medical care measures to reduce the burden
of medical costs for the elderly. The state has set up a medical subsidy program
for civil servants, and such expenditure, including the part for retirees, is
covered by the state revenue. The government encourages the establishment of a
subsidy system to cover hefty medical costs throughout the country. The fund
collected from individual or enterprise payments will be used to cover medical
costs in excess of the maximum coverage under the unified planning program for
employees and retirees who suffer from major, serious or chronic diseases.
Where conditions permit, enterprises have set up a supplementary medical
insurance system to cover medical costs in excess of the maximum coverage under
the basic medical insurance. The Chinese government is exploring ways to set up
a social medical aid system in cities by pooling medical-aid funds from many
channels, such as state revenue allocations, public lottery welfare funds and
public donations, to subsidize the medical costs of people in dire need. By the
end of 2005, experimental work had been conducted in 1,119 counties (cities,
districts, banners), providing medical aid in 1.633 million cases.
Experimental work began in 2003 to set up a new type of rural cooperative
medical system by pooling funds from individual payments, collective support and
government subsidies. By the end of June 2006, such experimental work had been
extended to 1,399 counties (cities, districts, banners), covering 495 million
rural dwellers. Up to 396 million farmers, and over 73 percent of the elderly
people in the experimental areas, had participated in this new type of rural
cooperative medical system. A total of 14.412 billion yuan had been paid in 282
million cases as subsidies to farmers covered by the new type of rural
cooperative medical system.
The central government requires local governments to give appropriate
preferential treatment to people over the age of 70 participating in the new
type of rural cooperative medical system to meet their special needs. A rural
medical aid system has been established, with funds from government
appropriations and public donations to help the elderly covered by the "five
guarantees" system and poor farmers to join the new type of rural cooperative
medical system. The medical aid system provides certain subsidies to poor
farmers whose high medical costs for serious diseases have affected their basic
family life, and has to a certain degree alleviated the basic medical burdens on
the aged. So far the rural medical aid system has been set up in all of the 31
provinces, autonomous regions and municipalities directly under the central
government. In 2005, a total of 1.08 billion yuan of medical aid subsidy was
given to farmers in 11.12 million cases.
Special activities to provide the aged with dedicated medical aid and healing
aid are going full steam ahead in China. The National Development Outline for
the Disabled and the Action for Helping Seniors to Regain Their Eyesight,
conducted mostly in the western areas, have given operations to about six
million elderly people in remote areas suffering from cataracts, and helped poor
and disabled seniors to recover or regain physical functions by providing
artificial limbs or hearing aids for free.
Developing Medical and Health Services for the Aged
The state has
strengthened the planning and leadership of medical and health work for seniors.
The Chinese government has formulated and implemented the Plan for Medical and
Health Work for Seniors in the Eighth Five-Year Plan Period (1991-1995), issued
policy documents twice on improving medical and health work for seniors,
including work in a series of health development plans such as the Outline for
National Health Education and Health Improvement Work (2005-2010), Outline for
the Development of China's Nursing Work (2005-2010) and Plan for China's Mental
Health Work (2002-2010). The National Health Work for Seniors Leading Group and
the Experts Consultative Committee for Health Work for Seniors have been set up
to strengthen the guidance, coordination and scientific decision-making in this
The state encourages large- and medium-sized medical institutions, where
conditions permit, to open special departments or outpatient departments for
senile diseases to provide specialized services to seniors. The establishment of
medical service institutions according to regional health plans is also
encouraged to help prevent and treat senile diseases, provide healing service
for the aged and hospice care. Priority and preferential treatment for people
over the age of 70 are generally provided in Chinese medical institutions in
terms of registration, treatment, obtaining medicine and hospitalization. The
Outline for National Economic and Social Development in the 11th Five-Year Plan
Period issued by the government in 2006 included the Nursing with Care Project
and speeding up the development of nursing facilities for elderly patients and
the disabled as key tasks.
The establishment of an urban community health service system has been
speeded up nationwide, with emphasis on medical and health work for the aged, so
as to provide safe, efficient, convenient and economical health services to the
elderly. Grassroots medical institutions all over the country are encouraged to
convert into community health service institutions, and to provide health care,
medical treatment, nursing and healing services for the aged.
By the end of 2005, over 15,000 community health service centers had been set
up in Chinese cities, and urban community health services were available in 95
percent of the cities at or above the prefectural level, and in 86 percent of
the districts under municipal jurisdiction and the county-level cities. With
visiting and taking care of patients at home, daily care and hospice care
provided by grassroots medical institutions according to the special needs of
the elderly, their health problems can be basically solved within the community.
In consideration of health and physical characteristics of the aged, the
Chinese government has made positive efforts in organizing hygiene and health
care publicity work. Radio, TV, newspapers and community bulletin boards are all
used to publicize common knowledge of how to keep fit and healthy in old age.
Hospitals at various levels provide regular health lectures throughout the year
to local communities, providing health advice to those suffering from chronic
The state has set the standard for healthy seniors, and organized national
public appraisals of healthy seniors as a way to promote a scientific and
healthy lifestyle. The "three-level prevention and treatment work" (of heart,
brain and blood diseases as well as diabetes and other chronic diseases) is
being stressed, and the prevention and treatment guidance and management plan
for high blood pressure and diabetes has been formulated and gradually promoted
to facilitate the early discovery, diagnosis and treatment of chronic diseases
related to old age. Starting in 1991, the Chinese government began to include
the prevention and treatment of senile diseases in the state scientific and
technological plan. So far, more than 50 institutions in the country are engaged
in research to prevent and treat senile diseases.
Promoting Mass Sports and Fitness Exercises among Elderly People
Chinese government promotes mass sports and fitness exercises among elderly
people with an aim to improve their physique and health. By the end of 2005, all
counties and higher administrative units, 70 percent of urban communities and 50
percent of townships in rural areas had established sports associations for
seniors, which are strengthening organization work and guidance for the mass
sports activities of the aged. In recent years, the state initiated the National
Fitness Project, which helps to set up public sports and fitnes s grounds and
facilities, and to provide space for elderly people to do physical exercises.
At present, there are over 30,000 such sports grounds throughout the country.
Since 2001, the "Millions of Seniors' Fitness Exercise Activities" organized in
China have attracted more and more senior participants, so it is estimated that
there are now more than 58 million elderly people doing regular sports and
fitness exercises in China.