CHINA URBAN SCHEMES

General Information

After the launch of the NRCMI in 2003, the group of urban economically inactive residents is the sole large one left with no State-organized HI cover. It is estimated that this group comprises as much as up to 240-300 million people (Ma Kai, 2007) with four sub-groups, namely children, the elderly, the disabled and other economically inactive working-age persons. Another characteristic of this group is its large proportion being those from poor and low-income households. The Government attempts to extend the HI coverage to this last vulnerable group by the HIUR system and aim to achieve a wide coverage by 2010.

When the State Council announced its decision on the development of the HIUR in March 2007, it laid out a number of principles as follows: a), It will be jointly financed by contributions from the insured and fiscal subsidies from the Government; b), The focus of the protection will, in principle, be placed on severe diseases-related medical care, both outpatient and inpatient cares include, and all other hospitalization cares; c), Unlike the existing urban HI for enterprises’ employees, no component of individual savings accounts is to be included.

At the Conference, the Premier drew some detailed guidance lines for piloting the HIUR in selected regions: a), Each locally-designed and run scheme should determines a sound financing level and a sound benefit package, which is consistent with the financing capacity of the targeted people in different regions as well as the subsidizing capacity of the local governments. The financing of each local scheme may start from a relatively low level, which can be increased gradually at the late stage following the development of local economies. One of the primary objectives is universal coverage. b), The participation in this scheme is voluntary, but the local governments should encourage their people to join it through incentive policies. c), A range of regulations on financing and accounting need to be set up to secure an efficient management of the inflow and outflow of the fund. d), Government’s subsidies are to be reinforced. The subsidy from the Central Government will be transferred in full and in time, which is mainly allocated to the Central and Western Regions. The subsidy from the local governments should be fully and timely transferred too.

Premier Wen the development of the HIUR should be put into the ongoing reform of the whole health system and in particular, should made best use of the introduction of a community-based primary health care-provider mechanism.

According to Vice Premier Wu, Head of the Inter-Ministry Committee for the HIUR of the State Council, pilot proposals from 79 cities have been approved and are to be launched before the end of September 2007. The Committee will conduct an assessment of the piloting schemes and propose an extension plan in the early 2008.