CHINA RURAL SCHEMES

 » The Hanshan NRCMI scheme

 

No. of communes: 10 Land area: 1,047 km sq. Total population: 442,400 Rural population: 358,447 GDP: 3.01B yuans GDP per capita: 6,781 yuans GDP per capita rural pop.: 3,135 yuans County govt income: 102.87M yuans

http://www.ahhs.gov.cn/hzyl/index.htm

Substantial elements of the Hanshan NRCMI scheme

The scheme has been in operation since 2004. Constrained by the size of this report, the number of elements reviewed in this case study will be limited to two.

Financing

A quick review of the income sources and rates is given in Table 4.


Compared with its counterpart in Xiaoshan, the financing aspect of this scheme has the following features: (a) as Hanshan is classified as a poor county, the scheme is entitled to the full range of government subsidies, but the overall subsidy rate remains the same; (b) the contribution rate is 50 per cent lower, which brings the overall income rate down and makes the scheme more dependent on the government subsidy.
Unlike the Xiaoshan NRCMI scheme, the Hanshan scheme has introduced the family savings account to finance outpatient treatment. Therefore, the revenue has to be split between the two funds as shown below.


The above table shows that the government subsidy is devoted entirely to the pooled funds, while the contribution is split equally between the two funds. As a result, 83 per cent and 89 per cent, respectively, of the income was allocated to the pooled funds in 2005 and 2006, and the rest to the family account component. It seems that by such an allocation structure, the management tried to match, as closely as possible, the benefit structure that placed a heavy emphasis on hospitalization and other serious disease-related benefits.

Benefits

It comprises five categories, namely ailment-related outpatient care, hospitalization, specified serious disease-related outpatient care, other high-cost outpatient care, and maternity care. The first is granted against the family savings account and the others against the pooled funds. The last two were recently added to the benefit package by the 2006 Regulation in a lump sum form. As far as specified serious disease-related outpatient care benefit is concerned, the number of diseases included increased from 8 to 12 over the period of 2005-2006, and 20 per cent of the related medical cost falling in the segment of 1001-5000 yuans in 2005 or 301-5000 yuans in 2006, respectively, refunded. Similar to everywhere else, the category of hospitalization is the focus of the whole benefit package. Table 6 gives some detailed provisions.


Compared with that of the Xiaoshan scheme, it is quite curious to see that the benefit level under this one is higher either in terms of reimbursement rates or in terms the deductible and benefit ceiling, despite less income.
Like other schemes, the benefit offered here has generally increased following the rise of income in 2006. For instance, the overall ceiling for benefits payable by the pooled funds rose from 16,000 yuans to 30,000 yuans.
It is prescribed by the Regulation that if there is extra savings at the end of a year, a second round of benefits may be accorded.

Progress achieved

Of 358,447 targeted rural residents, 301,281 or 84.05 per cent were actually covered in 2005, which has slightly risen to 85.20 per cent in 2006.
A total of 5,948 claims for reimbursement were approved in 2005 with a payment amounting to 4.84 million yuans . During the first four months of 2005, 1.17 million yuans against 5.1 million yuans as the total medical expenses, about 22.9 per cent, were reimbursed. It was 22.09 per cent for the first quarter of 2006.
On the financing side, it received 9 million yuans in 2005, of which 3 million yuans came from the insured households and 6 million from the government. It is anticipated for 2006, the overall revenue will be increased by around 50 per cent due to the rise of 15 yuans in the government subsidy.