According to an article in China Outlook, much of the Chinese government would be ecstatic to discuss the success of the New Cooperative Medical Insurance Scheme (NCMS). This health insurance plan is aimed to cover the majority of the rural Chinese, and was launched nearly a decade ago. The article sites cites that nearly 99%, or 800 million individuals, are now covered by the plan. So why would anyone be dissatisfied with what seems to be an affordable universal health care plan?
The article goes on to say that health care costs have risen and continue to do so. [We read about the quality of the service in Country Driving.] It remains unaffordable to the rural people of China. The structure of the NCMS, upon investigation, is seriously flawed in regards to the reimbursement rates. The average officially claimed reimbursement rate for inpatient covered under NCMS is only 55%, meaning that the rural farmers are having to pay nearly half of all medical costs out of pocket.
The steep costs even lead a 47-year-old farmer to amputate his right leg because he couldn’t afford the medical bill. However, this wasn’t even the first incident to occur that is related to affordable health care. The article further states that in early December, a group of elderly people in a rural village committed suicide because they felt they were becoming a monetary burden to their children.
Well… I am not sure why the cost is too high. I thought the point of having universal health care was to make health care affordable for everyone. In the documentary we had to watch for homework, there was an old lady who went to the doctor. She might need a surgery but she was not dare to have the surgery because she could not afford it. So health care is necessary for people like her (esp. rural areas as you mentioned above). If it is flawed, then they must fix the problem. For ex. half of the cost is really high for the farmers.
Insurance takes many forms, and may in this case have a fixed low per diem cap that is (as the post notes) far below actual rates, thanks to the [small] magnitude of adjustment over time. China’s system suffers from the flaws common to largely private healthcare systems. In the US and in China, hospitals and doctors are free to charge whatever they think they can. As large purchasers insurance companies can sometimes negotiate and contract rates in advance – so in the US a well-off individual with insurance is charged much less than a poor person without insurance. (The difference isn’t small – it’s not unusual for a poor person to be charged 3x more.)
In China the insurance system obviously doesn’t do that, or doesn’t do that successfully; patients are charged cash up front. If you’re a seriously ill peasant you aren’t in a position to argue or bargain, and once the money’s been handed over, you’re not going to get a refund just because the official charge is supposed to be less.
I know no details however of health insurance in China – the above is inference from my general knowledge of healthcare systems. It’s worth a term paper….
Does China need its version of ObamaCare (the PPACA)? Perhaps yes. Fortunately, it would be much easier to implement an effective individual mandate in such a central economy. Will this happen? It remains to be seen.