CHINA RURAL SCHEMES

 » The Dunhuang NRCMI Scheme

No. of communes: Land area: 31,200 km sq. Total population: 180,000 Rural population: 96,900 GDP: 2.03B yuans GDP per capita: 4,660 yuans County govt income: 113.61M yuans

Substantial elements of the Dunhuang NRCMI scheme

Numerous studies have indicated that in the Western region, around 20 per cent of the population is below the poverty line, which is about 19.92 per cent in Gansu Province. Disease-caused poverty is more severe in this part of China. For instance, the Dunhuang Government estimated that among its rural poor households, 50 per cent were brought down by a serious disease suffered by a family member who had no medical insurance.
In Gansu, the pilot exercise started in five selected counties in 2003 and one year later, nine more counties were added, including Dunhuang. Again, due to the limited size of this report, only two aspects of the scheme will be reviewed here.

Financing

Table 7 displays its income structure and individual rates effective for 2005 and 2006, respectively. It is interesting to note that, in spite of low rural per capita income, the contribution rate is set at the highest level among the three schemes reviewed in this paper, which consequently brings its global income rate to the top.


Like its counterpart in Hanshan, the Dunhuang NRCMI scheme also has a component of family savings accounts to finance medical treatment of ailments. Meanwhile, the pooled component is further divided into three parts, namely hospitalization, serious diseases and reserve funds. Thus, once the income is received, it is reallocated into four funds covering different contingencies at a distribution rate illustrated by Table 8.


Compared with the Hanshan scheme, the proportion distributed to the family account component is considerably high here: 34 per cent in 2005 and 24 per cent in 2006.

Benefits

Three types of benefits are granted under the three funds, namely outpatient care, hospitalization and serious disease costing more than 20,000 yuans per single visit.
Concerning outpatient care benefit, the claim is submitted for processing to the designated bank where the family account was set up and the allocation deposited. The balance from previous years can be carried over. If no benefit has been claimed during the last two years, the insured person is entitled to a health check at a commune medical centre, the cost of which can be shared equally between the family account and the hospitalization funds.

In respect of hospitalization and serious disease benefits, Table 9 gives more details on evolving deductible, ceiling and reimbursement rates.



In 2006, two more benefits were added to the category of hospitalization: (a) a lump sum payable to those who have either been affected by one of the six prescribed serious diseases, or have given birth to a baby in compliance with the national policy on family planning; (b) the reimbursement rate is higher for those who have proved their determination not to have more children after having had one, whether it is boy or girl, or two daughters.

Progress achieved

During its first-year operation in 2005, it attracted, out of 94,524 rural residents, 87,662 participants with a coverage as high as 92.74 per cent; 3,086 claims for hospitalization and serious diseases benefits were approved with a total payment equal to 2.16 million yuans, about 700 yuans per claim on average.
In 2006, it has covered 88,985 people or 93.77 per cent of the targeted population. The first two months have seen 945 claims for hospitalization and serious disease-related benefits approved with 0.71 million yuans paid.