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China's social security white paper (full text) 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.
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