Social Security Programs in Rural China
The rapid transformation from a planned to a market economy and from an agrarian society to an industrial society poses a great challenge to the traditional elderly care and healthcare system in the Chinese society. Following the rural economic reform in the 1970s, the communes were dissolved and the power of village collectives has been reduced. Many rural health clinics have disappeared since the rural reform, affecting the provisions of healthcare. Private medical practitioners provide services according to patients’ ability to pay, an increasing number of people have had to bear the full cost of medical care. Consequently, severe illness has become a major cause of falling into poverty. Meanwhile, the traditional family-based elderly support system has been in jeopardy after the implementation of one child policy in the early 1980s and massive migration among adult children to cities far away from home since the 1990s. In response to these challenges, the Chinese government has made tremendous effort to set up a new rural social security system to protect the poor and vulnerable. This session brings together three paper on two major healthcare and elderly support programs in rural China. The first two papers investigate people’s health behaviors and health services utilization in response to the New Rural Cooperative Medical Scheme (NRCMS) launched in 2003. The third paper examines household decision making, especially health services utilization, intra-household transfers and mutual help, under the New Rural Pension Scheme (NRPS) implemented since 2009.