China's rural medical care system will cover more than 80 percent counties,
said Premier Wen Jiabao at the opening meeting of the Fifth Session of the Tenth
National People's Congress (NPC) in Beijing on Monday.
"The trial area of the new type of rural cooperative medical care system will
be expanded this year to cover over 80 percent of all counties, county-level
cities and city districts in China. Areas possessing the proper conditions may
expand the trial faster than others," said Wen in the government work report
delivered to 2,890 NPC deputies at the annual session of the top legislature.
The allocations from the central government budget to subsidize this trial
will amount to 10.1 billion yuan (US$1.3 billion) this year, a 5.8 billion yuan
(US$750 million) year-on-year increase, according to the government work report.
NPC deputy Li Changshui, a village head from Hunan Province, said the move
shows the strong commitment and resolution of the central government in
improving the lagging-behind rural health service system in the approach to
build a new socialist countryside.
Under the new cooperative medical care program launched in 2003, a farmer
participant pays 10 yuan (US$1.3) a year, while the state, provincial, municipal
and county governments jointly put in another 40 yuan (US$5.2) for the
The participant can have part of his expense reimbursed in case he is
hospitalized. The rate of reimbursement varies according to different kinds of
illness and the actual cost of medical expenses incurred.
Rural Chinese people used to have access to subsidized health clinics run by
"barefoot doctors", who were mainly middle school graduates trained in first
aid. This service, essentially free, helped almost double the country's average
life expectancy from 35 years in 1949 to 68 years in 1978.
When China began its economic reform in the early 1980s, the old system was
ended as the country attempted to switch to a market-oriented health care
system. But the government failed to establish a viable substitute, leaving
almost 90 percent of the rural population without health insurance, according to
the Ministry of Health.
In 2003, the average annual income for China's 745 million rural populations
was 2,622 yuan (US$328) while the average medical expenses were 2,236 yuan
(US$280) according to the Ministry of Health in 2004.
A national health survey in 2003 revealed that about 73 percent of people in
rural areas who should have sought medical treatment chose not to do so because
of the fear of high cost.
"Once the ambulance siren wails, a pig is taken to the market; once a
hospital bed is slept in, a year of farming goes down the drain; once a serious
disease is contracted, 10 years of savings are whittled away," said a well-known
Chinese countryside saying.
Thanks to the new cooperative scheme, 410 million farmers among 1,451
counties had joined the program, accounting for 50.7 percent of the country's
total, said the government work report.
So far, China's central and local governments have invested over 18.9 billion
yuan (US$2.4 billion) into the medicare scheme.
A survey jointly conducted by Beijing University, the Chinese Academy of
Social Sciences, the Ministry of Agriculture and the Ministry of Health released
early this year found that more than 57 percent of rural families that joined
the system had made claims by 2005.
Families were reimbursed 25.7 percent of their total medical expenses, with
an average refund of 731 yuan (US$95) according to the survey that polled 19,195
rural families in 32 counties of 17 provinces.
It also showed that 90 percent of families who participated in the program
are willing to stay in the system.
However, the national drive also faces difficulties.
"Some counties and towns do not have enough financial power to supply their
portion in the fund," said NPC deputy Xu Geliang, a hospital head in Anhui
In addition, many clinics are in shortage of eligible doctors and equipment.
In over 1,600 clinics in China's east Anhui Province, there are only 723 college
graduates, less than two percent of the total number of doctors. Half of the
clinics are not equipped with stomach pumps and 30 percent without
For village clinics, the situation is even worse.