Authorities across China have recently announced changes to employee health insurance lengthening the total overall contribution period to 30 years for men and 25 years for women.
The move has sparked heated online debate, with many suggesting that repeated rounds of mass COVID-19 testing has emptied out government healthcare coffers, leaving regular people to foot the bill.
When the scheme started, women in the southern province of Guangdong were paying into the scheme for a maximum of 20 years, and men for 25 years.
The longer compulsory contribution period for all employees took effect from July 1, 2022.
A resident of the central Chinese city of Wuhan surnamed Gao said he has been asked for additional contributions by his employer to make up the shortfall in minimum contributions.
"In the past, medical insurance payments were limited to 15 years, and you could enjoy lifelong medical cover after that," Gao told RFA. "Before, both men and women paid for 15 years."
"Now that the regulations have been revised, the burden on ordinary people will be heavier, whether they can afford it or not," he said. "This has a huge impact; some people have shorter working lives, and it's simply not possible for them to contribute for 30 years."
Mass COVID-19 testing
Gao blames the incessant rounds of mass testing for COVID-19, which has drained government coffers of more than 300 billion yuan, he said.
The government is now seeking to make up the shortfall in funding with extended contributions from employees, he said.
"There must be a problem with funding; otherwise it wouldn't skyrocket like that all of a sudden," he said.
Guangdong-based sociologist Zhang Yang said the problem is now very serious, because not many people are in a position to pay into the system for three decades.
"Many people can't even get work by the age of 25 nowadays," Zhang said. "Graduates or doctors are of necessity over 30 years old [due to the length of their studies or training]."
"Now the government is asking people to keep paying out for 30 years, but you only pay social and medical insurance if you have a job," he said. "If you don't have a job, you can't pay in."
The eastern province of Shandong was the first to lengthen minimum contribution times at the end of 2021.
Spreading across China
Zhang said similar moves are now afoot across China, and will leave more people forced to pay out of pocket for their own medical care.
"It's like going back to where we were 20 years ago ... when there was no rural cooperative medical care period, so farming communities had no coverage," he said. "That was gradually sorted out under President Hu Jintao."
"But now, what they are asking people to pay for medical care may be too much," Zhang said.
The government is also seeking to cut costs by excluding certain types of drugs from insurance coverage.
According to China's National Medical Insurance Administration, 995 kinds of drugs, including non-steroid anti-inflammatory drug (NSAIDs) and herbal Ganmaoling capsules, have been excluded from the list of reimbursable drugs.
A social welfare researcher who gave only the surname Mao said the moves have been on the cards for some time now.
"The cost of PCR testing in various places is paid from the medical insurance fund," Mao said. "They have gone through the medical insurance premiums paid in by employees and have to extend the payment period for medical insurance to make up for it."
Translated and edited by Luisetta Mudie.
This content originally appeared on Radio Free Asia and was authored by By Gu Ting for RFA Mandarin and Chingman for RFA Cantonese.
By Gu Ting for RFA Mandarin and Chingman for RFA Cantonese | Radio Free (2022-07-19T10:31:18+00:00) Extended compulsory medical insurance payments spark concerns over coverage in China. Retrieved from https://www.radiofree.org/2022/07/19/extended-compulsory-medical-insurance-payments-spark-concerns-over-coverage-in-china/
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