Tuesday, 29 January 2013

China's most needy missed out on medical insurance

When Liao Dan, a 41-year-old Beijing resident, appeared in the Dongcheng District People's Court on July 11, 2012, facing charges of defrauding Beijing Hospital of medical fees, sympathy was so overwhelming that some netizens called for his acquittal.
Liao had forged an official stamp to evade medical fees for his wife, Du Jinling, who suffered from acute kidney disease. The couple, married 15 years with a 12-year-old son, earned little more than the government living allowance of 1,700 yuan ($270) per month. Laid off during a spate of state-owned bankruptcies a decade earlier, the meager and unstable income Liao earned as a manual laborer was nowhere near enough to cover the costs of Du's biweekly dialysis treatments, nearly 5,000 yuan ($794) per month.
Since Du is from Yixian County, Hebei Province, and does not have a stable job in Beijing, she would have had to return to her hometown to receive treatment eligible for medical insurance reimbursements. Liao doubted his wife could stand frequent travel between Yixian and Beijing. Sobbing several times during court, Liao testified, "I could not find any other way and just wanted to keep her alive."
According to Liao's lawyer, money donated by the owner of a software company in southern Guangdong Province to cover the medical expenses owed was among the reasons the court showed lenience in sentencing Liao on December 7, 2012. Instead of sentencing him to up to a decade in jail, as proposed by prosecutors, the court fined Liao 3,000 yuan ($476) and gave him three years in jail with four years' reprieve for defrauding the hospital of 172,000 yuan ($27,300) from September 2007 to November 2011.
Netizens donated over 500,000 yuan ($79,400) to pay for Du's future treatment.
Although China's basic medical insurance program had covered more than 95 percent of its population by the end of 2011, Liao's case once again sheds light on the urgency for the country to institute a universal social safety net to protect the most vulnerable and disadvantaged groups.
Sun Shuhan, a professor at the Beijing-based Renmin University of China, said people like Du, who are married to Beijingers and work and live in Beijing, should be able to have their medical bills refunded locally rather than be forced to return to their hometowns for treatment.
However, Lu Xuejing, a professor at Capital University of Economics and Business who studies social security policies, stands in opposition. She said that if government-sponsored medical insurance is available to all immigrants living in Beijing, it would place an enormous burden on medical facilities in the capital, where the most advanced medical resources in the country are located. "The local budget will not stand the pressure either," she said.
China's medical insurance system is segmented as each province has its own medical insurance fund, which only pays for the expenses of its registered residents.
Gu Xin, a professor at the School of Government of Peking University, said that in the long run, difficulties faced by families like Liao's could only be solved if medical insurance accounts were better consolidated fro smooth transfer between localities around the country.
Gu said that he had designed a universal health insurance system, where each citizen pays an annual premium of 200 yuan ($32) him or herself and receives 500 yuan ($79) in subsidy from a state-financed national health fund. The 700-yuan ($111) annual premium is calculated based on China's current medical consumption level. Under Gu's proposal, premiums for low-income earners would be entirely paid for by the government.
Source: Beijing Review

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