Health insurance reform: How are senior people and retirees affected?
A nurse explains the new health insurance reform to patients in Huai'an, east China's Jiangsu Province, February 12, 2023. /CFP
A nurse explains the new health insurance reform to patients in Huai'an, east China's Jiangsu Province, February 12, 2023. /CFP

A nurse explains the new health insurance reform to patients in Huai'an, east China's Jiangsu Province, February 12, 2023. /CFP

China's health insurance reform has become a hot topic in the country's social media and a focus of some Western media. Some say the senior people and retirees are being hurt by the reform in a way that it takes away their money.

But as CGTN Digital recently reported, it is also worth noting that these people are among the most benefited ones in the reform. As the cash is being taken away, more health services are provided and weighted toward elderly people.

According to figures released by the National Healthcare Security Administration (NHSA), China's working population paid 2,097 yuan ($306) on average for medical expenses in 2021, whereas retirees spent 8,002 yuan, or more than 3.8 times as much.

"Obviously, elderly people are more susceptible to illness and incur higher medical expenses," said Wang Chaoqun, associate professor at Central China Normal University, adding that senior people's personal accounts are far from sufficient to cover their needs for outpatient care and pharmaceutical purchases.

To lighten the financial burden on elderly patients, the authority made it clear that local governments should weight the system more heavily toward retired people by raising the reimbursement rate of their outpatient bills based on the threshold of 50 percent.

Favorable policies for elderly people have been rolled out in the city of Hohhot, North China's Inner Mongolia autonomous region. Retired employees enjoy a higher reimbursement rate for outpatient bills compared with working people.

Under the new scheme, the insured are allowed to use the money in their personal account to help their elderly parents as well as other family members.

By doing so, Chinese families will be in a better position to cope with medical risks, said Gu Xuefei, a medical care policy researcher at the China National Health Development Research Center.

How people feel matters

Highlighting the importance of how people feel about the reform, Gu said the impact on stakeholders, including the public and medical institutions, should be taken into full consideration.

He called on all players to join hands in helping ease the process of acquiring medical treatment.

The reform, with is expected to be completed in three years according to official plans, is still in its initial stages. Most regions have rolled out their policies, though measures may vary from one to another due to the disparity in economic strength and the depth of insurance coordination.

It takes time for any reform to take effect, said Wang Zhen, a public economics scholar at the Chinese Academy of Social Sciences, adding that supporting measures should be taken at the same time, such as being reasonable when adjusting the payout thresholds and maximum payment limits in the reimbursement of outpatient bills, bringing more eligible pharmacies into the system where outpatient expenses can be reimbursed by the pooled fund, and incorporating internet-based medical services into the coverage of insurance.

Optimization has been underway in some regions. In Central China's Wuhan, for example, 4,065 pharmacies have been newly added to the system, supporting efforts to cover outpatient expenses through unified accounts, in addition to the more than 1,000 pharmacies previously brought in under a pilot scheme.

(With input from Xinhua.)

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