Medical charges have always been a headache for the majority of farmers in China. Reforms in the medical system have been going on across the country for several years now. So is farmers´situation changing for the better?
People often used to say ironically that you could have nothing but money and everything but disease. This was especially true for farmers. Some were driven to poverty and heavy debts because one family member fell ill. Some would never go to hospital even if they were seriously ill and suffered unbearable pain because they couldn´t afford the usually very high medical charges. To change this situation, a pilot medical welfare scheme has been launched in the Huairou District of Beijing. You may wonder how farmers are being affected by this scheme.
Medical charges for urban residents were often completely covered by their work units in the past. This is no longer feasible today. For farmers who don´t have much income of their own, there is still a long way to go before the medical welfare scheme is perfected so that every one of them can enjoy its benefits.
Seventy-year-old Li Jishu, who lives In a village in Beijing´s Huairou District, missed her step and broke one of her legs while walking outside her house early this year. This caused quite some trouble for the family as the village is not really adequately supplied with medical equipment.
Li Jishu’s son Cao Baoxiang is a well-known filial son in the village. He spared no efforts to get his mother well treated. He has been running small businesses in recent years and earned some money, but for him the 10,000-operation charge was not a small sum. Fortunately the village has in the past few years launched a medical welfare plan for the villagers, and Cao Baoxiang was able to get 3000 yuan of medical compensation – it is quite a relief for the family.
This rural medical welfare scheme was launched in 1990s in Huairou district. It aims to ensure basic medical services for the farmers. According to this scheme, a farmer can get a maximum of 3000 yuan of medical compensation if he contributes 6 yuan of premiums every year. Zou Shengjin, vice director of the local health bureau, was one of the initiators of the plan.
In fact, a cooperative medical system closely related to the commune distribution system became the major form of rural medical insurance in the 1960s, and was recognized even by the international community. But the system dissolved with the breaking up of the commune system, and the gradual marketization of the health system. It has become increasingly more difficult for farmers to afford medical charges. Farmers may be driven to poverty through illness. In 1997, Huairou District launched a new type of cooperative medical scheme. A special office was set up to popularize the scheme among the farmers, which opened a new channel for farmers to subsidize their medical expenses.
Though this new medical scheme was effective in helping farmers to gain reimbursement for their medical expenses, it was far from enough to cover all their expenses, since when the plan was first launched, quotas on reimbursement were set too low. So many of the farmers were not interested in this plan, and some even held misgivings concerning it.
In order for the farmers to understand the real benefits of this cooperative medical scheme and to get rid of their doubts, officials at all levels in Huairou district went from door to door to publicize the plan. Some villages even assumed all the medical expenses for their farmers so that they could enjoy the cooperative medical service sooner.
With patience and painstaking efforts on part of the local officials, the farmers´ awareness of the availability of medical treatment was enhanced, and many of their misgivings were removed. The state health department also made improvements to the new cooperative medical plan, and quotas on reimbursement were raised. In 2003 the maximum reimbursement increased to 30,000 yuan: now farmers can really enjoy the benefits of the plan.
Zhu Hongchun lives in a village in Huairou District. He was struck by a sudden myocardial infarction April this year. The high medical charges for treatment cast a grim shadow over this not so well-to-do family. But the family finally emerged from under this cloud thanks to 26,000 yuan of medical reimbursement from the medical welfare scheme.
Farmers have seen with their own eyes the real benefits of the welfare scheme, and feel greatly encouraged. In the less than five years between 1998 and 2002, the number of farmers registering for the welfare scheme rose from 1,500 to over 100,000. This new type of cooperative medical scheme is being improved in China´s rural areas. They don´t have to worry too much about medical charges when they are seriously ill. Poverty caused by illness has gradually become a thing of the past, and farmers today also hold different views.
Huairou district is populated by 180,000 people, and the bulk of village affairs rely on less than 3,000 village cadres. However, in the past, these village cadres had no guarantees for their daily life expenses after retirement. This greatly affected their enthusiasm for work. In 1991, Huairou district promoted a pension insurance system for them as part of the social security system in rural areas.
The pension insurance system met with a warm reception from the village cadres, and by the end of the 2002, over 800 retirees had taken their pensions, a total of more than 6 million yuan. Yuan Zhenling in the district now relies on her pension to enjoy her retirement.
Once their retirement is guaranteed, these village cadres are relieved from a lot of worry, and their passion for work has also increased, as has their overall quality.
Social security system in the rural areas is improving and the effects have begun to show. More than 90 percent of the farmers have entered the medical welfare scheme, and all the village cadres now have pension insurance. With social stability and cadres feeling at ease during their working lives, the rural economy has also shown rapid growth, offering the further necessary guarantees for the rural social security system. Starting from this year, the medical welfare plan in Huairou has entered its second phase, and the plan is now being popularized in China´s other rural areas.
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