Funded Trading Plus: China’s Publicly 1.4 Billion

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Why have millions of people left China’s publicly funded health insurance program?

Funded Trading Plus: China’s Publicly 1.4 Billion

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This year, teachers at Mata School in a remote village in western China were given a “political task” for the first time: ensuring that every student is enrolled in the nation’s basic health insurance program.

The local government of Shaanxi province ordered the school in Zizhou county, which serves underprivileged and troubled children, to encourage parents to make sure their kids are insured.

Deputy principal Ma Jun stated that families were unsure whether to stay in the program given the increasing premiums and their stagnant incomes.

The program’s lack of enthusiasm is a perfect representation of China’s state health insurance system’s declining enrollment, which is having long-term shrinking workforce and an aging population are testing financial health.

Although it served more than 96% of China’s 1.4 billion people between 2019 and 2021, the National Healthcare Security Administration (NHSA) reports that between 2019 and 2021, it dropped by more than 1%, or roughly 17 million subscribers.

For workers in formal employment, the Urban Employees’ Program is required. It offers better financial coverage and benefits, and both employers and employees contribute to the premiums.
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According to the NHSA, the number of people who signed up for the urban employees’ program increased by more than 8 million last year, as many migrant workers relocate from rural areas to cities in search of employment amid urbanization. Conversely, about 25 million people left the urban and the plan of the rural populace.

For a significant portion of the population, who still have low incomes, paying the premium is a major hardship.

For many years, policyholders could only file claims in a single province due to the fact that local governments oversee the state health insurance program. As a result, some migrant workers obtained plans in both their hometown and place of employment.

However, the issue was resolved last year when cross-province reimbursement became possible.

With two parents and two kids, my family of six requires 2,280 yuan in payment. It’s not a small amount for a rural family, particularly in hard times financially, according to Li Nian, a resident of a northern Hebei province village that is part of Handan city. Li Nian has chosen not to

enroll themselves or their spouse in the financial savings plan.

Retired professor Zhu Qizhen, who focused on rural issues, claimed that some rural residents are beginning to question the value of the coverage due to the rising co-payments.

Some people, particularly the younger ones who think they’re healthy enough, also have a tendency to push their luck.

According to Zhu, some people might think it’s a waste of money if they don’t have any claims to make.

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He noted that premiums paid under the health insurance plan for urban and rural residents are cleared annually, in contrast to auto insurance, which permits the insured to pay less in the subsequent year if no claims are made.

Beijing promised to boost the subsidy this year by 30 yuan (US$4.2) per policyholder, or a total of 30 billion yuan.

Li proposed that “we should decide on personal contributions based on individual income, and give them the same treatment when they go to the hospital” in order to lessen the strain on both parties.

She claimed that this is an illustration of equality using the current approach, which she called “equalitarianism.”

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