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A pilot cooperative medical scheme for migrant workers, the first ever in China, has proved successful since it was started in March 2005. By the yearend 1.24 million migrant workers were covered under the scheme, which involves 5,500 enterprises and 132 medical units, according to a Workers' Daily report on Tuesday.

Guan Lingen, director of the Shenzhen Labor and Social Security Bureau, said that the scheme will benefit more migrant workers in 2006, an estimated 3 million by the end of the year, and will not be restricted to workers in the manufacturing industry.

Under the scheme, migrant workers pay four yuan (US$0.5) per month into a special fund, which covers them for outpatient and inpatient medical services. Their employers pay eight yuan per month for them. Of the monthly deposit, six yuan goes toward outpatient medical costs, five yuan to inpatient costs, and one yuan to emergencies.

Outpatient medication is also covered under the scheme. The cost of category A and B drugs, as classified under the national basic medical insurance system, is reduced by 80 and 60 percent respectively.

Further, workers insured under the scheme do not have to pay for outpatient visits that cost less than 90 yuan.

The scheme also provides cheaper services in Class I, II and III hospitals in the city and Class III hospital outside of the city. Costs are 90, 80, 70 and 60 percent less respectively. The ceiling for the annual reduction of inpatient cost is 60,000 yuan.

"I spent only seven yuan to treat a cold and a throat inflammation. It's so cheap," said Wang Jiangyue, a female migrant worker from Shaanxi Province. The seven yuan she paid covered three injections and two days' worth of medicine, which would have cost her between 70 and 80 yuan otherwise.

Liu Xiaosha, a migrant worker from Henan Province, said that the medical insurance cover he had previously only paid for inpatient costs. "Two outpatient visits to treat a cold cost me 200 yuan before. But now, under the new scheme, I can save 100 yuan a year," he said. 

Another worker, who asked not to be named, said: "In the past, when someone fell ill, he or she would have to go to a hospital several kilometers away or buy some medication from a roadside drug store. Now that the healthcare center in the community has joined the pilot scheme, it's more convenient and safer for us to see a doctor."

According to Shen Hualiang, another official with the bureau, 132 medical units were appointed for the pilot scheme, of which 18 are hospital headquarters, and 114 subordinated community health care centers or stations. Of these units, six are private, and the other 126 are government-funded.

In addition, workers covered by the scheme are issued with a "Labor and Social Security Card."

When the scheme first started, many enterprises chose to take a wait-and-see approach. Seeing the initial success of the scheme, they realized that it would actually be beneficial for them to participate in it.

Liu Jinhua, a manager with Shenzhen-based Fuqun Group, said that the company buys medical insurance for over 6,000 employees at a cost of 25.5 yuan per month for each person. "Now, we only have to pay eight yuan per month for each person, which means we save about 100,000 yuan every month."

In line with Shenzhen's policies, enterprises had to pay the equivalent of 8 percent of employees' monthly salaries toward medical insurance between 1992 and 1996; from 1996 to 2003, this was reduced to 2 percent of monthly wages; from July 2003, the rate of contribution was further reduced to 1 percent.

Medical facilities, especially grassroots medical institutions, also benefit from participation in the scheme.

"Before we joined the scheme, our monthly revenue was between 10,000 and 20,000 yuan. It's now about 60,000 yuan. We are much busier than before," Ye Huizhen, superintendent of Bantian Health Care Center under Buji People's Hospital in Longgang District, told Workers' Daily.

For Dalang Community Health Care Center in Longhua Town, the annual turnover before they joined the scheme was about 200,000 yuan. Now, the center, with a register of 46,000 migrant workers covered under the scheme, earns about 276,000 yuan in outpatient fee every month for providing cooperative medical service from the city's Cooperative Medical Insurance Fund Management Center.

Another advantage of the scheme is that it is forcing unlicensed medical or health care centers that typically overcharge patients to close.

The scheme also gives patients the freedom to choose a medical center or hospital in which to receive treatment. And with a wider distribution of medical services, the scheme is in line with the country's policy that encourages patients to seek treatment for minor conditions in community or neighborhood medical centers, resorting to hospitals only in case of more serious ailments and emergencies.

According to public health statistics, average outpatient costs in the three city-level Class III hospitals of Shenzhen are double that of a community hospital, while hospitalization costs are 3.1 times more. Under the scheme, the average outpatient cost for a migrant worker was 56.76 yuan, much lower than the 134.5 yuan the city's urban resident had to pay in the first half of 2005.

The bureau plans to implement the scheme across the city this March. 

(China.org.cn by Zhang Yunxing, February 10, 2006)