Med­i­cal re­funds give hope to im­pov­er­ished ru­ral house­holds

China Daily (Hong Kong) - - CHINA -

When I en­tered Zheng Liang­shui’s house, I could hardly believe the 50-year-old farmer has been se­verely ill with cancer. That was be­cause his well-fur­nished three-story home, con­tain­ing a tri­cy­cle-trailer, a mo­tor­cy­cle and elec­tri­cal ap­pli­ances, in­di­cated a de­cent stan­dard of liv­ing for a ru­ral res­i­dent.

Ap­pear­ances can be de­cep­tive, though. In truth, Zheng’s fam­ily, in Macheng, a city in Cen­tral China’s Hubei prov­ince, is des­per­ately poor.

The fam­ily once made a good liv­ing by run­ning their own pig farm, but in 2014, Zheng’s wife, Tao Congx­i­ang, 49, was di­ag­nosed with sep­sis.

The fam­ily spent about 100,000 yuan ($14,700) on treat­ment, but the med­i­cal re­fund sys­tem re­im­bursed less than half the sum. It never rains but it pours. In June last year, Zheng was di­ag­nosed with stom­ach cancer, which was a huge blow, both phys­i­cally and fi­nan­cially.

The fam­ily sud­denly found it­self with no source of in­come; Zheng and Tao were too sick to work and their only child is a mid­dle school stu­dent. To make mat­ters worse, all the pigs had been sold to pay Tao’s med­i­cal bills in 2014.

The lat­est round of med­i­cal ex­penses choked the fam­ily, which was charged 38,000 yuan for surgery to re­move part of Zheng’s stom­ach and a fur­ther 10,000 yuan for two ses­sions of chemo­ther­apy.

How­ever, un­der the poli­cies in place at the time, ru­ral pa­tients could claim a re­fund of up to 75 per­cent of their med­i­cal fees if they were treated at county-level hos­pi­tals. The sum was re­duced if they at­tended hos­pi­tals above that level.

That meant Zheng, who was treated at the county hos­pi­tal, ac­tu­ally paid 20,000 yuan for the stom­ach op­er­a­tion and 2,700 yuan for the chemo­ther­apy ses­sions.

Even with the re­fund, the cost was too much for the fam­ily to bear.

Things be­gan to change in Oc­to­ber, when “pre­ci­sion” poverty al­le­vi­a­tion mea­sures were in­tro­duced to en­sure that ev­ery im­pov­er­ished house­hold in Huang­gang, the city which over­sees Macheng, has ac­cess to a new pref­er­en­tial med­i­cal pol­icy.

The new pol­icy of­fers im­pov­er­ished fam­i­lies re­funds of up to 90 per­cent of their fees in des­ig­nated hos­pi­tals in Hubei. The en­tire fee is re­im­bursed if the pa­tient is an or­phan or a se­nior with no fam­ily sup­port.

As a re­sult, when he had an­other two ses­sions of chemo­ther­apy, Zheng paid less than 1,000 yuan, about one-third the cost of pre­vi­ous ses­sions.

In ad­di­tion, Zheng now only pays 10 per­cent of the cost of the medicine he takes ev­ery day. That means he pays 157.5 yuan for a box of tablets that pro­vides treat­ment for 10 days, but the true price is 1,575 yuan. If not for the re­fund, Zheng would not be able to af­ford the tablets he will need to take for at least a year.

He is for­tu­nate, though, be­cause as a pi­o­neer city, Huang­gang has achieved the 90 per­cent re­im­burse­ment by in­clud­ing in­de­pen­dent com­mer­cial in­sur­ance in the med­i­cal re­fund sys­tem.

Ac­cord­ing to data from the Na­tional Health and Fam­ily Plan­ning Com­mis­sion, 5.53 mil­lion house­holds — 7.34 mil­lion peo­ple — are mired in poverty as a re­sult of med­i­cal costs.

The cen­tral gov­ern­ment has vowed to lift all the coun­try’s ru­ral poor out of poverty by 2020, but some will in­evitably sink back into poverty as a re­sult of ma­jor ill­nesses.

Zheng’s fam­ily has been struck by ill­ness twice, but has man­aged to largely with­stand the im­pact be­cause they now only pay a frac­tion of the heavy med­i­cal costs.

How­ever, their case is not unique in Huang­gang. Most house­holds clas­si­fied as im­pov­er­ished in the vil­lages un­der its ju­ris­dic­tion have at least one fam­ily mem­ber with a se­ri­ous ill­ness.

Now, the fam­i­lies not only en­joy a high level of med­i­cal re­im­burse­ment, but also ben­e­fit from pref­er­en­tial poli­cies re­lated to is­sues rang­ing from agri­cul­tural pro­duc­tion to ed­u­ca­tion.

The mea­sures help fam­i­lies to en­dure tough times caused by ill­ness, and en­cour­age them to stand on their own feet once things im­prove.

Huang­gang’s med­i­cal re­im­burse­ment pol­icy solves a fi­nan­cial prob­lem that once af­fected many fam­i­lies, and it de­serves to be ex­panded na­tion­wide.

What’s more im­por­tant is that the high level of re­im­burse­ment and other pref­er­en­tial poli­cies give hope to farm­ers such as Zheng and help them believe they can live longer and have an op­por­tu­nity to raise their liv­ing stan­dards.

Now his health is im­prov­ing, Zheng is sup­port­ing the fam­ily by work­ing as a driver. He be­lieves that if the fam­ily pulls to­gether, they can live the good life once again.

Con­tact the writer at wuyan@chi­


Wu Yan in­ter­views a doc­tor in Macheng, Hubei prov­ince.

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