According to the World Bank, between 2011 and 2015, China’s under-five infant mortality rate decreased from 14.5 to 10.7 percent, respectively. This improvement has been realised in part through efforts by the Government of the People’s Republic of China to scale up access to health care with the introduction of several new insurance based schemes between 1998 and 2007. These schemes have been designed to target both urban and rural residents through tailored programming in order to make health care more accessible to all Chinese. China’s health care schemes are implemented by the Ministry of Civil Affairs, the Ministry of Human Resources and Social Security, and the National Health and Family Commission, through a network of more than 16,000 hospitals.

China’s health care system consists of a series of schemes, which together, are designed to reach the entire population. Public sector employees are covered under the Public Free Medical Service, which is a non-contributory scheme established in 1952 to cover 100 per cent of medical costs. Those employed in the formal sector in urban areas are covered under the Urban Employee Basic Medical Insurance (UEBMI). UEBMI is a contributory scheme requiring 6 per cent contributions from employers and 2 per cent contributions from employees and covers approximately 64% of medical costs for claimants. Unemployed urban residents are eligible for coverage under the Urban Residence Basic Medical Insurance (URBMI) scheme, which provides coverage at approximately 50% of medical expenses on the basis of minimal contributions. Further, urban residents with low income can access health care under the Medical Assistance for Urban Resident’s (MAUR) scheme, a non-contributory scheme introduced in 2005 to provide subsidies to contribute to MIUR or receive direct assistance. Rural residents of China are covered under separate schemes, including the New Co-operative Medical Scheme (NCMS) which was launched in 2003 and covers approximately 50 per cent of the claimant’s health care expenditures. This scheme is complimented by the Medical Assistance for Rural Residents scheme which is structured much like the MAUR and provides rural residents with a subsidy to join the NCMS or receive direct assistance. Together China’s targeted health care schemes reached approximately 95 per cent of the population in 2011 with hopes to reach 100 per cent coverage by 2020.

China’s health care policies date back to 1949 with the introduction of a limited public health care system. This health care system has undergone several reforms, the latest in 2007, in order to meet the needs of a large population. While much progress has been realised, some challenge still remains in moving toward a more integrated approach, which could increase coverage and reduce administrative costs. Nonetheless, China’s health insurance schemes reach a large portion of the population and are an important step in moving toward the social protection floor.

Further Reading:

• Ministry of Human Resources and Social Security, China (2012). Rapid extension of the Chinese health insurance coverage: A case of the Ministry of Human Resources and Social Security. International Social Security Association, Geneva.
• International Labour Organization, (2016) China Healthcare Coverage to All 2016.