China Healthcare
Ageing China faces rural healthcare vacuum
Nov 23, 2006 - 3:06:54 PM

Beijing, Nov 23 (DPA) Rapid socio-economic changes and the effects of China's one-child family-planning policy mean that many elderly members face old age with virtually no healthcare.

Elderly farmers across China have a common saying about healthcare: 'Small illness, don't check; big illness, await death'.

'The main problem in China is that we have become old before we became rich,' said Wang Guixin, a demographer at Shanghai's Fudan University.

'The situation in developed countries is that they are rich enough to afford the expenditure on old people, but we are not,' Wang said.

'The speed and spread of the ageing problem in China is quite fast,' he added.

About 143 million, or 11 percent, of China's 1.3 billion people are over 60 years old. The number of over-60s is forecast to hit 13 percent or 174 million in 2010 and 30 percent in 2050.

The ageing of Chinese society is most acute in Shanghai, its largest and wealthiest city.

But in Shanghai and most urban areas, retired people get basic pension and healthcare through local social-security coverage or their former state work units.

However, in most rural areas, where two-thirds of China's population still lives, there is almost no coverage for ordinary people.

Labour and Social Security Minister Tian Chengping said last month that different forms of pensions covered only 19 percent of the estimated 918 million Chinese people of working age at the end of 2005.

More than 85 percent of rural elderly have no social-security benefits, with most relying on their families for support, said Yao Yuan, director of the Population Institute at People's University in Beijing.

The problem is only likely to worsen in the coming decades.

The one-child policy was introduced in the late 1970s after Mao Zedong's policy of encouraging more births in the 1950s and 1960s.

These 'baby boomers' will cause a new surge in the number of over-60s in the next 25 years.

They already suffer from the '1-2-4' problem of a single child sometimes having to care for not only two parents but also four grandparents.

'The one-child policy has accelerated the ageing of the Chinese population,' Yao said. '(But) the ageing problem is inevitable whether or not we conducted the one-child policy.'

In a report last year, the World Bank urged the central government to consider direct funding of local health initiatives or find other ways to reduce the need for local governments in poor areas to fund healthcare.

A small-scale health-insurance programme has proved popular. Farmers pay 30 yuan (about $4) per person annually in return for coverage of 70 percent of any medical expenses over 10,000 yuan.

'But this policy has not been expanded on a large-scale in China, especially in poor areas,' Yao said. 'It still needs more financial and strategic support from the central government.'

Another pilot scheme provides a token annual allowance of 600 yuan to elderly residents without sons in some rural areas.

In the absence of pensions and modern healthcare, some people turn to Chinese medicine or even superstition.

Thousands of elderly people joined the Falun Gong spiritual movement, which was banned in 1999, in the belief that its breathing and meditation exercises could cure their health problems.

The number of elderly people joining spiritual and religious groups is still rising, especially among women, Yao said.

Yao saw other demographic trends affecting the demands on the government to care for China's ageing population.

'More and more rural young have moved to urban areas to make a living there,' Yao said, often leaving elderly parents in their home villages.

Wide imbalances in economic development have exacerbated the problems, Wang said.

'Modern healthcare cannot cover some poor or remote areas,' he said.

'If they cannot get money from relatives or sons and daughters,' Wang added, 'they can only wait for death.'

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