A new mother in Jinan, China, has just given her newborn a special first gift. Right after delivery, Ms. Liu used her phone to enroll her baby in the national basic medical insurance system. She did it all from her hospital bed.
This simple process is now common across China. New parents only need their child’s birth certificate to sign up. This is part of a major effort to improve China’s basic medical insurance system.
The system has become easier to join. New rules also encourage people to enroll and ensure they get paid quickly.
These changes are key goals of China’s 14th Five-Year Plan (2021-2025). A new plan for the system’s development will start next year.
Nearly everyone in China is now covered. The recent enrollment rate has stayed stable at around 95%.
From 2021 to 2024, the insurance system processed about 20 billion reimbursements. This information comes from Zhang Ke, head of the National Healthcare Security Administration (NHSA).
How the System Works
China’s public healthcare security has two main parts.
- One is for rural residents and non-working urban people. It is paid for by both individuals and the government.
- The other is for urban employees. It is paid for by both workers and their employers.
For years, China has worked to make this insurance cover more people and more services. It now includes things like maternity care and long-term care insurance. The goal is to make healthcare easier to get.
Easier Access and Bigger Rewards
This January, the NHSA made new rules. They let flexible workers join medical insurance where they live or work. They no longer need to go back to their official hometown to register.
People who keep their insurance without a break get a reward. Their payment limit for critical illness insurance goes up.
During the 14th Five-Year Plan period, critical illness insurance helped 673 million low-income people in rural areas. It reduced their medical costs by over 650 billion yuan (about $91.34 billion).
Researcher Guo Minjiang says this incentive mechanism is important. It balances “fairness” and “efficiency” in the basic medical insurance system.
Expanding Coverage and Services
Now, 31 provincial-level areas and the Xinjiang Production and Construction Corps pay for assisted reproduction through medical insurance.
Long-term care insurance is being tested in 49 cities. Nearly 190 million people are part of this trial.
As of June this year, 253 million women had maternity insurance. The basic medical insurance fund has paid out more than 438 billion yuan in maternity benefits.
NHSA Deputy Director Li Tao said the administration will keep working with other departments. They want to create a long-term care insurance system that eventually covers everyone.
Breaking Down Barriers and Embracing Technology
The system is also breaking down old barriers. People can now use money from their medical insurance accounts to pay for their family’s medical bills. Their family includes spouses, parents, and children.
The list of drugs covered by insurance keeps growing. It now includes over 3,000 different medicines. Across the country, there are 1.1 million medical institutions that accept the insurance.
Technology is making everything easier. “In the past, you needed a card, had to queue, and copy documents to see a doctor,” said Mr. Li, a patient in Yinchuan. “Now, you just need to have your face scanned.”
Digital tools do more than just make access easier. They also help find fraud and protect insurance funds.
The NHSA says China has built a strong system to supervise the medical insurance fund. This system has helped recover over 100 billion yuan.
“This year, unannounced inspections have covered all regions and all parties using medical insurance funds,” said Huang Huabo, another deputy head of the NHSA.
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