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The extremely cold weather that has ravaged large parts of the northern hemisphere this winter also took its toll on the small village of Dazhuyin in Ganyu County, east China’s Jiangsu Province. The dry, freezing days laid low scores of villagers who suffered from bad colds and coughs. Thirteenyear-old Liu Jingdi was one of those affected badly by the cold, and had to be hospitalized at the nearby Longhe hospital.
Liu was put onto an intravenous drip, which he said made him feel much better and for which his father paid 15 yuan ($2.38).
“Thanks to the new rural cooperative medical system, our payments for medical treatments have been cut greatly,” said Liu Shunqiang, the boy’s father. “Before the system [was implemented in Ganyu], it was impossible to have medical treatment for less than 100 yuan ($15.87) even for a slight cold.”
Cheap healthcare
Liu is one of the 1.07 million Ganyu people who have been benefiting from the new rural cooperative medical system, which was implemented in Ganyu County as a pilot project in September 2003.
According to the system, each person who voluntarily participates pays 50 yuan ($7.94) a year to his or her account and gets a medical card; and in turn the government subsidizes 240 yuan ($38.1) to the account each year. With the medical card, the patient can go to any county, town and village-level hospitals and enjoy a 45-percent cost reduction for clinic treatments and up to 85-percent reduction for hospitalization. Meanwhile, the system also requires all designated hospitals to sell medicines at cost price. Liu Shunqiang said he could see more than two-thirds reduction in his medical treatment expenditure since the system began. Liu’s family was among the first to participate in the system in 2003.
“The new rural cooperative medical system has been greatly benefiting patients by reducing their expenditures on medical treatment,”Liu Shijun, a doctor of Longhe hospital, told ChinAfrica.
Doctor Liu noted that before the medical system was implemented in Ganyu, doctors’ salaries were paid from hospital profits, but now as many hospitals (including Longhe) do not make profit due to the cost reduction in medical treatment, it is the government subsidies that sustain the operation.
The new system is influencing not only local hospitals, but also farmers in their attitudes toward medical treatments.
According to Doctor Liu, before the new system was launched, many patients were reluctant to go to hospital when they got sick because of the high cost of medical treatment. Many would rather buy cheap medicines from drug stores than go to see a doctor.
Official statistics show that a Ganyu farmer’s net income in 2003 was only about 3,300 yuan ($523.8); in contrast, the average rural expense for treatment of a serious disease is more than 7,000 yuan ($1,100). “A serious disease can drop a family in a rural area into heavy debt, especially in poor Ganyu County,” said Doctor Liu.
Doctor Liu said he and his colleagues now treat more than 150 patients a day. “In winter when the cold is rampant, we have to treat more than 200 patients a day,” he said, adding that this figure is many times higher than pre-2003.
Real benefits
It is true that the new system can ease farmers’ burdens in their medical treatments. however, the system did encounter its challenges at first. The greatest difficulty was how to persuade farmers in Ganyu County’s 436 administrative villages in 18 towns to sign up.
“When we explained the new medical system to farmers, many of them hesitated to pay the membership fee, because they could not see the benefit they could get from the system,” Wang Jingyuan, former Director of health Bureau of Ganyu who was in charge of developing the new medical system, told China Economic Weekly.
To solve the problem, Wang conducted an in-depth investigation and found that those who had benefited from the system were likely to continue their membership as they had seen tangible benefits.
Based on his findings, Wang initiated a new mode of raising funds. When patients who did not join in the system came to see a doctor, they could also enjoy a 45-percent reduction in payment. But the deducted money was put into their medical accounts. When their funds reached the amount required by the medical system, they could enjoy future benefits.
Wang’s initiative worked and now figures from the Administration Office of New Rural Cooperative Medical System of Ganyu County show that all the farmers in the county are included in the system in 2012.
“The main reason [for the success] is that we showed farmers they can get concrete benefits when they get sick,” Wang Lei from the administration office told ChinAfrica.
Regulation required
Ganyu is not the only county to carry out the new rural cooperative medical system in China. Figures from the Office of the Central Rural Working Leading Group show the medical system has now covered 97 percent of farmers nationwide.
“Given this large amount of people involved, it is necessary to have a national law to regulate the operation of the new rural cooperative medical system,” hao Ping, a deputy to the 11th National People’s Congress, told legaldaily.com.cn.
however, since the medical system is carried out independently with varying standards in different counties, currently there is no national law to regulate its operation.
Jiangsu is the first province to develop a province-level regulation in this field. After years of investigation and research, the Standing Committee of Jiangsu Provincial People’s Congress adopted the Regulations of Jiangsu Province on the New Rural Cooperative Medical System, which came into effect on June 1, 2011.
Meanwhile, Gansu Provincial People’s Congress listed similar legislation into its plan of 2012.
however, hao doesn’t think the efforts are enough.“There is no unified national law, and this is the major problem in further developing the medical system,” she noted. At the 11th National People’s Congress session held in March 2011, she proposed to legislate a national law on the medical system.
“The new rural cooperative medical system should be ensured by a complete legal system consisting of a national law, regional regulations and statutes, so as to protect farmers’ legal interests and put the medical system on the right development track,” she said.