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Coal-rich County Offers Free Medical Care for All

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At 80, Mao Yuyie lay on a hospital bed for the first time without having to worry about her medical bill.

The peasant farmer in northwest China's Shaanxi Province is among the first in China to enjoy free medical care, thanks to a new policy of her home county government in Shenmu.

The coal-rich county with 400,000 people near the sprawling deserts of western China has earmarked 150 million to 180 million yuan (US$22 million to 26.4 million) of its revenue annually to cover residents' medical expenses.

Under the new policy, inpatients can get 90 percent of their medical expenses refunded; and outpatients can get an annual maximum refund of 60,000 yuan, said the county's top official, Guo Baocheng.

Guo, secretary of Shenmu county committee of the Chinese Communist Party, said the patients were free to choose any of the three county hospitals. But for serious cases such as terminal cancer, organ transplants and other critical surgery, they could also choose leading hospitals in the provincial capital, Xi'an, or Beijing.

The county had expanded a preferential treatment, previously enjoyed only by government employees, to all residents, including peasants and the unemployed.

When the policy took effect on March 1, it was widely criticized as a spur-of-the-moment idea and exuberance by the county government.

Many people still doubt whether this Utopian policy will last, because even in the country's most developed regions, peasants and unemployed urban dwellers can only get up to 50 percent of their medical expenses refunded.

However, Mao, who used to spend her meagre pension on cheap, over-the-counter medicines to treat her hypertension and heart disease, says the new policy has saved lives. "How come people criticized the government for such a good policy?"

"It's all because people know too little about Shenmu," said Guo. "The county's revenue reached 7.2 billion yuan last year, of which 1.7 billion was designated local fiscal expenditure."

This year, Guo said the county's revenue would top 10 billion yuan. "The 150 million to 180 million yuan government spending on public medical services is no problem."

By the end of September, almost 20,000 people had claimed refunds on their medical bills, which totaled 78.8 million yuan. The county government predicts the budget will see the year out.

The county's rich coal reserves and annual output of 100 million tonnes are an important driver of sustained economic growth. This year it ranked 59th among China's 100 richest counties, compared with the 92nd last year.

"The free medical service was just one of the county government's moves to improve the quality of people's lives," said Guo.

The public spending on medicine would take only an eighth of the county's 1.3 billion yuan spending on public welfare this year, said Lei Zhengxi, head of the county government.

Other public welfare programs included 12 years of free education, better housing for peasants and urban poor, and poverty relief, he said.

The county offered 12 years of free education for all children, whereas in most parts of the country, free education lasts only nine years.

"Rural children who board on campus also get a daily food allowance of 3.5 yuan a day each," said Lei.

Elderly people and children who are unprovided for also get free lodging and meals at the county's welfare homes, Lei said.

Zhao Yun, deputy head of Shaanxi provincial human resources and social security department, said he appreciated the county government's efforts. "But it's not possible to promote the practice in poorer counties anytime soon."

Ministry of Civil Affairs official Wang Zhenyao praised Shenmu County’s move as "pioneering". "It aims to resolve a crucial issue facing many Chinese: staggering medical bills," said Wang, who is in charge of social welfare and charity work. "The move actually promotes harmony and economic growth."

High medical expenses force many Chinese, peasants and unemployed people in particular, to avoid going to hospital until their ailments become serious.

"We hope Shenmu County will continue its efforts to improve public welfare, and encourage other developed areas to follow their example," said Wang.

(Xinhua News Agency November 13, 2009)

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