CHINA URBAN SCHEMES

HIUR schemes in Jiangsu Province

Provincial-wide launch in Jiangsu. It is the first province in China where all provincial-run cities have launched the HIUR scheme. “Guidance on setting up the HIUR” was issued by the Provincial Government in March 2007. Some characteristics of the schemes operated in this province are described blow:

Earlier pilot. The scheme has been implemented for one year in a number of the cities in Jiangsu Province, such as Huaiyin and Suzhou.

Targeted people: 12 million. Of them, 1.53 million persons have been covered so far.

• Suzhou: the coverage rate is about 80% now, only one year after the implementation.
• Yancheng: due to a range of policies in favour of those from low-income families and highly disabled persons, persons from these groups have almost all participated in the HIUR scheme.

Financing: The minimum financing rate is set at 150 yuans per insured and per annum by the Provincial Government. The city authorities are allowed to raise it if the local economic conditions are permitted.

• Yancheng: the financing rate per insured per annum is set at 200 yuans, of which, 140 yuans by the insured and 60 yuans by the local governments. For those from low-income households, the ratio of contribution to subsidy is 60 yuans: 140 yuans.
• Suzhou: the financing rate per insured per annum is 350 yuans, of which, 100 yuans from the insured and 250 yuans from the Government. But the contribution share of low-income households, high-level disabled persons, and orphans is exempted and replaced by a same amount of subsidy from the Government.

Benefits: They focus on outpatient care of severe diseases and hospitalization mainly through risk and financing pooling for treating severe diseases.

• Yancheng: the low-income group and the high-level disabled persons enjoy further policy advantages, i.e. certain out-patient costs are reduced by 30% and certain in-patient costs reduced by 50%, whilst one service cost is exempted. The maximum amount of reimbursable benefits is 30,000 yuans per insured per annum.
• Suzhou: the maximum amount of reimbursable benefits is 100,000 yuans per insured per annum.

Community-based medical services: They have two advantages: Firstly, the cost for treatment is relatively low. Secondly, the services are available at door sep, as they are located inside the residential communities where the insured live. Therefore, many local HIUR schemes encourage the insured to use these services by lowering threshold fee and raising reimbursement rate.

• Huaian HIUR has advanced one step more: it uses it as a gatekeeper. There are a total of more than 70 contracted community medical centres in this city, each of the insured has to choose one of them as his or her family doctor. However, the insured can change his or her choice on an annual basis. Therefore, these community medical centres are improving their facilities and services to compete with each other for current 80,000 insured persons, which will be raised to 250,000 when the targeted people have all been covered.

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