Yang Chengcai, an 82-year-old villager in southern Guangxi Zhuang Autonomous Region, has benefited from the new medicare system in which the government pays part of the medical expenses while the patient pays the rest.

"I have just undergone an operation at the town hospital, and 867 yuan (US$105) of the 2,180 yuan (US$263) medical expenses was reimbursed by the government," said Yang.

"In the past when I was ill, I usually did not dare to go to hospital for fear of the high medical expenses. But now, with the new medical system, I can go to see a doctor any time when I don't feel well," Yang said.

According to a notice issued by the Ministry of Health, the Ministry of Finance and the Ministry of Agriculture in January 2003, China will reestablish its medicare system and from 2003 all regions in China will conduct tests in two or three selected counties.

In the 1960s and 1970s, a simple but effective medicare system was established in China's vast rural areas, which have traditionally been short of doctors and medicines. At that time, many part-time paramedical workers were trained in simple techniques of diagnosis and treatment, and prevention was put first in rural medical work.

But such a basic medicare system could not meet the increasing demand of China's 900 million farmers for better medical services as only patients who were not seriously ill can get treatment from the medical care system for which they paid almost nothing.

When farmers, most of whom are still not very wealthy in China, get serious illness and have to be hospitalized, the high medical cost always reduce them to poverty and ruin or prevent them from taking treatments from the hospital.

A survey of the medical expenses of farmers in three counties in the Guangxi Zhuang Autonomous Region -- Luchuan, Pingguo and Tengxian -- made by the local department of health shows that medical expenses are a great burden for villagers.

Among the 41,000 farmers in Pingguo County, on average each goes to see a doctor twice a year, and the annual per-capita medical expenses are only 51.4 yuan (US$6.2). The annual average income of these farmers is 1,391 yuan (US$168), but farmers who have been in city-level hospitals have had to pay as much as 2,774 yuan (US$335) a time.

Different from the old system, the new medical care system pays more attention to subsidizing farmers who got serious illness.

According to the new medicare system, a medical fund will be established for each farmer joining the system on their own wills, in which the farmer pays at least 10 yuan (about US$1.2) every year while the local government pays the same amount.

And to subsidize farmers in western and central parts of the country where are still less developed and poor, from 2003, the central government began to pay at least 10 yuan (about US$1.2) for each farmer joining the system in this region.

As an experiment, in 2003, the new medical care system was promoted in the three counties of the Guangxi Zhuang Autonomous Region.

Some 1.175 million peasants, about 59.8 percent of the total number of farmers in the three counties, joined the new medical system, and 5.665 million yuan (US$684,435) of the medical cost last year was reimbursed by the government, nearly 45 percent of the total medical cost.

"This year, the new medicare system will be spread to 11 more counties," said Tan Mingjie, the deputy director of the provincial health department.

According to Tan, for every 10 yuan (about US$1.2) a farmer pays, the central, regional and city governments will pay twice that amount.

"Now, farmers can get 25 to 40 percent of their medical expenses reimbursed, and this percentage will be higher in 2004," said Tan.

"The establishment of the new medicare system will not only benefit the peasants but also be of great significance for the improvement of health work in China's rural areas as a whole," said Chen Ruiping, director of the health bureau of Luchuan County.

According to statistics from the region's health department, the income of 51 town and village hospitals in the three counties from last July to October was 16.58 million yuan (US$2,003,165) 14.66 percent higher than that of the same period of 2002.

And the number of farmers going to see doctors has greatly increased. For example, the number of patients at a hospital in Luchuan County increased from 623 in June to 1,392 in October.

"With more patients and more business income, we have been able to buy advanced medical equipment, and the services offered by our hospital have obviously improved greatly," said Yao Xihui, deputy director of a town hospital.

"Doctors are more professional, and the medical environment and services are much better than before," said Yang Chengcai.

Up to now, China has conducted experiments in selected counties and plans to have this new medicare system cover all its rural areas by 2010.

(Xinhua News Agency February 4, 2004)