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More Chinese people opted out of the voluntary health insurance scheme for urban and rural residents in 2024, adding strain to an already stressed system amid economic woes and eroding public confidence, reported the South China Morning Post (SCMP). The decline in participation continued last year, with 15.8 million fewer people enrolled compared to 2023, the National Healthcare Security Administration (NHSA) reported on Monday (July 14). Overall, China's basic medical insurance, which also includes a separate programme for urban workers, covered 1.326 billion people in 2024—a drop of 7.27 million from the previous year.
The falling participation rate poses a challenge for China's health insurance system, which is already under strain from a rapidly ageing population and a shrinking workforce. Rising premiums paired with stagnant incomes have driven the decline in participation. "The trend of less interest in participation continues because the economic conditions have not changed – it's a financial burden for a rural family if the breadwinner doesn't see their income increase," said Professor Xiong Wansheng, an expert on rural development at the East China University of Science and Technology.
Residents paid 400 yuan (about $56) each last year to join China's urban-rural insurance scheme, with the government chipping in 670 yuan, making a total of 1,070 yuan per person. That individual contribution was up 5 per cent from the year before. "Another reason why people are weary is that they don't trust the medical system. As premiums increase and medical treatment becomes more expensive, they find the scheme is not helping much," Xiong said. Despite the drop, the NHSA noted that over 95 per cent of the population is still covered by basic medical insurance, though it didn't provide details on how that compares year-on-year.
Editor: CH
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