Urgent need for China to address public health
Rural poverty and those left impoverished by severe illness present a serious challenge to Beijing, which must act swiftly or face political and economic risks
At the same time as China continues to lift millions more above the poverty line, the number falling below it because of illness and rising medical costs is growing. As a result, despite a doubling of spending on poverty over the past five years, the proportion of impoverished rural people who owe their plight to severe illness in their families has risen over two years from 42 to 44 per cent, according to Liu Yongfu, director of the State Council Leading Group Office of Poverty Alleviation and Development.
This counter trend is now one of the two biggest obstacles to the national goal of raising all families above the poverty line by 2020. The other is the challenge of eradicating rural poverty, especially in remote areas where it is deeply rooted and poorly served by social services and infrastructure, and a shortage of basic medical services.
Many people in these areas face difficulties they cannot overcome without extra help through sustained relief strategies.
This has prompted Beijing to target the impoverished living in the most remote areas and those further disadvantaged by illness. Liu left no one under any illusions about the scale and depth of the problem. He said six provinces had more than three million people below the poverty line, including ethnic Tibetan areas of Sichuan and southern parts of Xinjiang, and at least 20 per cent of the populations of nearly 30,000 villages were deemed impoverished.
It would be very difficult to lift these areas out of poverty in less than four years. A heavily subsidised public medical insurance scheme has limited coverage, reflected in a national survey showing that 7.34 million people from 5.53 million families were living under the poverty line last year because of severe illness.
Li Bin, minister for the National Health and Family Planning Commission, told the National People’s Congress in August the commission had an action plan to help families affected by severe illnesses such as leukaemia, congenital heart disease and some cancers. Insurance reimbursements would rise by 5 per cent for the rural poor and another scheme would cover the medical expenses arising from severe illnesses.
Given the scale of rural destitution and the narrowing time frame for eradicating it, the authorities need to advance these and other initiatives with a sense of urgency.
Decades of economic reform and growing prosperity have actually widened the wealth gap between the rural poor and their city cousins. Amid an ageing population, if the government does not address the public health care issue it could potentially become a political and economic one.