Establishing a New Rural Cooperative Medical Service System
In order to guarantee that farmers' basic medical needs are satisfied, to
alleviate their medical burdens and to address the problem of poverty caused by
illness or prevent them from getting poor again because of illness, in 2002 the
Chinese Government began to set up a new rural cooperative medical service
system based mainly on a financial-pool-against-serious-disease scheme. Farmers
can participate freely in such a cooperative medical system, which is organized,
led and supported by the government with funds coming from the government,
collectives and the beneficiaries. At present, the system is being tried out in
310 counties (cities) in 30 provinces, autonomous regions and municipalities
directly under the Central Government. By June 2004,the system had covered 95.04
million rural residents, with 68.99 million participants and 3.02 billion yuan
in raised funds, of which 1.11 billion yuan was in the form of financial
subsidies from local governments at various levels, and 390 million yuan was in
the form of Central Government subsidies to the central and western regions.
Practicing Rural Social Relief
The "five guarantees" system was initiated in China in the 1950s.In 1994, the
State Council issued the "Regulations Concerning the Work of Providing the 'Five
Guarantees' in the Rural Areas." It stipulates that elderly people, disabled
people and minors meeting the following conditions in rural areas can enjoy the
"five guarantees" of food, clothing, housing, medicare and burial expenses
(compulsory education for minors): Those who have no legal guardian to provide
for them, or whose legal guardians are unable to provide for them; those who
have no working ability; and those who have no source of income. To take care of
elderly people in the "five guarantees" category who cannot look after
themselves alone, homes for the aged have been built, and have gradually become
a major form of providing the "five guarantees" for the elderly. By the end of
2003, there were 2.545 million people covered by the "five guarantees," and
24,000 homes for the aged providing accommodation for 503,000 elderly people in
this category.
In view of the uneven economic development and the large disparity in
financial conditions between regions, the Chinese Government encourages areas
with adequate capacity to establish a system that guarantees the minimum
standard of living for rural residents. In other areas, the basic subsistence
relief system covering destitute households is practiced under the principle of
"government relief, social mutual help, offspring support and stabilized land
policy." Meanwhile, medical relief is provided for sick farmers who are in great
difficulty. By the end of 2003, there were 12.57 million poverty-stricken people
in rural China who enjoyed the minimum living allowance and subsistence relief
for destitute households.
Conclusion
After years of experiments and practice, a social security framework with
Chinese characteristics has taken initial shape. However, China still has a long
way to go to develop its social security services to a satisfactory level. The
aging of the population will put more pressure on the old-age pension and
medicare expenditure, while the progress of urbanization will make the
establishment and improvement of a social security system covering both urban
and rural areas more urgent. More employees of non-state-owned businesses and
people employed in a flexible manner will be covered by the social insurance
system as employment forms become more diversified. All this will raise new
requirements for the smooth operation of China's social security system and for
the establishment of a long-term mechanism which will ensure the sustainable
development of the social security services.
To press ahead with the improvement of the social security system is an
important task for the Chinese Government in its efforts to build a moderately
prosperous society in a comprehensive way. The increase in China's overall
economic strength as a result of the sustained, rapid, coordinated and healthy
development of China's national economy, the implementation of the scientific
concept of overall, coordinated and sustainable development, and a social
security system suited to China's national conditions and established after many
years of exploration, will pave the way for China's social security system to
develop continuously. In the years to come, the Chinese people will benefit more
from the nation's development and progress, and enjoy more plentiful fruits of
its material civilization.
