Thursday, June 28, 2007

Health plan protects China's poor

Chinese hospital administrator Yang Xizhong is more than willing to talk about a new medical insurance scheme for farmers that has been extended to his county.

Waving his arms around enthusiastically, he explains how 90% of people in Chiping County, in Shandong province, now benefit from the government-backed scheme.

"Using this system, ordinary people really benefit," he says of the plan, in which the state pays part of the cost of the treatment.

"It solves the problem of going to see a doctor," he adds.

On a tour of the new wing of the Chiping County People's Hospital, Mr Yang introduces several bed-ridden patients who also give the new system their approval.

Farmers like these, Mr Yang says, would not have been able to afford hospital treatment before the introduction of the New Rural Co-operative Medical Scheme.

Success story

Even when you go outside the hospital - and away from Mr Yang's influence - people tell a similar story.

Twenty minutes drive away, in the village of Donglu, home to around 500 people, 75-year-old Huang Beiyou is recovering from treatment for an inflamed prostate.

A few months ago Mr Huang, who tends a herd of goats, spent more than 20 days in Mr Yang's hospital at a cost of around 10,000 yuan ($1,300). The government paid half.

"Before, when we became ill, we had to pay for it ourselves. Sometimes we couldn't afford the treatment so we didn't have it," he says.

Chiping County People's Hospital
Local communes used to pay for medical treatments

"But now the government reimburses part of the cost, so we can afford it more easily. This system is a lot better. The government is really looking after us."

The scheme that is receiving so much praise was first introduced in 2003 to a select few counties in China, but is now being rolled out to rural areas across the country.

In a keynote speech given in March this year at the National People's Congress, China's parliament, Premier Wen Jiabao said he wanted 80% of rural people covered by the end of December.

With the central government spending close to 10bn yuan ($1.3bn) on rural healthcare this year, the Chinese health ministry was able to announce that it had met that target just one month later.

The scheme itself is relatively simple.

Each farmer pays as little as 10 yuan ($1.3) a year to join the insurance plan. The government then adds a similar amount.

Each county can have slightly different rules, but in Chiping the local government will repay 30% of medical fees for treatment costing up to 2,000 yuan ($263), according to Mr Yang.

If the cost is between 2,000 and 5,000 yuan, the government pays 45%. Above that, it guarantees to pay half the cost.

New system

A new insurance scheme for the countryside became necessary after China introduced radical economic reforms in the 1980s.

Under the old system, farmers' medical costs were paid by local communes, but when these were disbanded, rural people were left to fend for themselves.

That left many people in the countryside unable to buy even basic medical treatment without seriously affecting their household finances.

Chinese medical insurance papers
The scheme has extended medical treatment to the poor

According to a popular countryside saying, a trip in an ambulance means a pig has to be sold at market, once a hospital bed has been slept in a year's farm earnings go down the drain and a serious illness requires 10 years of savings.

While experts both inside and outside China praise the new scheme for extending medical coverage to China's poorest people, there have also been some criticisms of the plan, not least over whether local governments have enough money to pay their share of the costs.

James Murray, of the humanitarian organisation Plan International, which runs medical programmes in Shanxi province, says rural areas have always received less health spending than China's towns and cities.

Rural areas have traditionally been allocated just 20% of total health spending, despite the fact that 70% of China's population live in the countryside, he says.

And he adds that if rural people are to enjoy all-round good health, there needs to be more emphasis on basic health education instead of just promising to reimburse farmers when they become ill.

"It's not only infrastructure, it's not only machines that are needed to achieve better health. The population needs to be aware of what causes diseases and how to prevent them," Mr Murray says.

He might be right, but that is not going to dampen the enthusiasm of health workers like Mr Yang about what has already been achieved.

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