China's rural cooperative medical insurance system, initiated in 2003 to offer farmers basic healthcare, has covered more than 80 percent of the country's rural population, China's health minister Chen Zhu said on Wednesday.
"By June 30, about 720 million farmers had joined the scheme, accounting for 82.8 percent of the total rural population," Chen said at a press conference held by the Information Office of the State Council.
Meanwhile, the rural medical cooperatives have expanded to 2,429 counties, county-level cities and city districts, covering approximately 84.87 percent of the country's rural areas, Chen said.
"By 2008, we hope the rural cooperative medical insurance system will cover all the country's rural areas," Chen said.
The four-year old rural medical insurance system is seen by many as a way to prevent Chinese farmers with virtually no medical insurance from being vulnerable to accidents or disease.
Under the scheme, a participant pays 10 yuan (1.3 U.S. dollars) a year, while the state, provincial, municipal and county governments supply another 40 yuan (5.2 U.S. dollars) to the fund.
When rural residents fall seriously ill, a proportion of hospital expenses will be covered from the pooled insurance. The rate of reimbursement varies according to different kinds of illness and the actual cost of medical expenses incurred. But many rural residents still complain that the percentage of medical costs covered by the insurance scheme is still inadequate.
Chen said a total of 24.147 billion yuan (about 3.17 billion U.S. dollars) was pooled for the fund within the first half year, including 1.47 billion yuan of central government subsidies, 13.08 billion yuan from the local government and 9.2 billion yuan from rural residents themselves.
"A total of 13.34 billion yuan was used within the first six months of this year as reimbursement to the farmers," Chen said, adding that 82.5 percent of the money went on in-patient charges and about 14.85 percent for out-patient services.
The rural healthcare system was once a core element of Chinese socialism. After the founding of the People's Republic of China in 1949, rural people had access to subsidized health clinics run by "barefoot doctors", who were basically middle-school students trained in first aid.
The primitive service, essentially free, played a role in doubling the country's average life expectancy from 35 years in 1949 to 68 years in 1978.
When China began its economic reforms in the early 1980s, the system was dismantled as the country attempted to switch to a market-oriented healthcare system. But the government failed to establish a viable substitute, leaving its large rural population without health insurance.
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 costs.
The plight of Chinese farmers has provoked national leaders to move to restore rural medical cooperatives and to establish a nationwide safety net of minimal medical insurance.
Minister Chen said the program, after being in operation for more than four years, has helped ease the chronic difficulty faced by Chinese farmers in paying medical charges and significantly improved rural medical services.
He said the country is working to establish a stable money-raising channel for the fund and efforts will be made to ensure that central and local government subsidies are allocated to the fund quickly and used efficiently.
But experts believe there is a long way to go before the cooperative scheme can meet the needs of the rural people.
Wu Ming, professor with the medical school of Peking University, told Xinhua in April, "With an average reimbursement rate for hospital fees only standing at a meagre 27.5 percent, the current subsidies are still utterly inadequate in dealing with grave and terminal diseases."
Chen also promised that the central authorities will enforce monitoring to ensure the safety of the fund and improve supervision to rural medical institutions to ensure quality medical services for the farmers.
Governments at various levels have been demanded to increase financial investment in rural healthcare and help more farmers to join the program, according to a five-year (2006-2010) government health plan adopted last March by the State Council.
Early reports said that China is also planning to provide medical insurance for 240 million unemployed urban residents, who were once excluded by the medicare net.
The program, to be carried out in 79 cities in the trial stage and planned to cover urban children, students and jobless adults, will eventually bring all urban residents under the umbrella of medical insurance by 2010.
Source: Xinhua
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