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Rural dwellers get better medicare service
Updated: 2004-10-24 10:01

Ten days before the expected birth date of her baby, Democo, a nomadic Tibetan in northwest China's Qinghai Province, made her one and a half hour journey to the country hospital. Already a mother of two children, it was the first time for her to give birth in hospital.

Fourteen days later, Democo came back home happily with her newborn daughter, without paying a penny for medical services. Thetotal charge, which was 200 yuan (24.4 US dollars), was covered bythe rural cooperative medicare fund, a new type of rural medicare service that the Chinese government has piloted since 2003.

"My family paid 60 yuan to join the fund last year, 10 yuan foreach family member... 60 yuan is not a small sum for us, but I think it is repaid," said Democo, who lived in Gangca County, 180 kilometers northeast to the provincial capital, Xining. Democo's family raises livestock and earns about 3,000 yuan a year.

In contrast with China's fast economic growth, medical service and people's health in rural areas remains worrying.

Currently, China has nearly 120 million people infected with hepatitis B virus and 840,000 with HIV/AIDS, most of whom live in the vast rural areas. Different from most urban workers, who enjoygovernment subsidies or are covered by medical insurance, villagers have to pay medical expenses themselves.

The outbreak of severe acute respiratory syndrome (SARS) early last year propelled the government to accelerate the pace in rebuilding a rural medical network. The government set a deadline of eight years for completion.

Under the government scheme, a villager only needs to pay an average of 10 yuan for medicare insurance. The central government and local government each pays additional 10 yuan for it respectively. The sum of 30 yuan will be deposited in the pool of a so-called rural cooperative medicare fund. In case of illness, avillager who has joined the fund can be hospitalized and has part of his/her medical expenses covered by the fund.

Farmers are asked to join the cooperative medicare program on avoluntary basis.

Niu Huimin, deputy director of the Health Bureau of Qinghai Province, cited a survey as saying that among Qinghai's farmers and herdsmen who had fallen ill, 40 percent did not have money to see a doctor. Thirty-eight percent borrowed money for medical feesand as high as 56 percent were pulled back into poverty due to illness.

"By covering part of their medical expenses, the new medicare cooperative system could largely ease rural people's worry of illness," he said.

Qinghai Province began its pilot of the cooperative medicare scheme in August 2003. By the end of that year, 866,500 people joined the fund. To September this year, the province reimbursed atotal of 12.34 million yuan to 91,387 villagers and herdsman.

"Beside the direct benefits to local people, the cooperative medicare scheme also effectively boosted the development of local medical services," Niu said.

Citing Gangca County as an example, Niu said the proportion of births attended by trained health workers in the county increased to 81.96 percent during the first six months of 2004, up from 65 percent in 2002. The number of patients who visited clinics and were hospitalized increased 39.9 percent and 97.6 percent respectively.

As a matter of fact, while being quite positive to the new pilot system, the Chinese government also appeared to be very cautious. President Hu Jintao and Premier Wen Jiabao urged local health authorities to be fully aware that the pilot was an "arduous and complicated" reform.

Nie Chunlei, deputy director of the rural health department under the Health Ministry, said China's rural areas covered large territory and the people's demands for medical services varied greatly.

"The central government has laid out the major principles and framework of the new cooperative medicare system, under which various localities experiment the patterns that are most applicable to their conditions," he said.

The latest statistics showed that by the end of last June, the new cooperative medicare system had covered areas with 95.04 million residents, among whom 68.99 million joined the system. Thecooperative medicare fund had reached 3.02 billion yuan.

At a national meeting on rural cooperative health care that ended here Saturday, Chinese Vice Premier Wu Yi, who is also health minister, urged local health authorities to recognize and solve the problems concerning the pilot project so that the program can be expanded to other areas of the country.

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