Poverty and disabled households in the People’s Republic of China: experiences with a new rural health insurance scheme

Abstract

This article discusses what in international literature has commonly been termed the ‘vicious circle’ of poverty and disability. Our aim is to shed light on recent policies that attempt to break the vicious circle in rural areas in the People’s Republic of China. Drawing on data produced from fieldwork conducted in the Inner Mongolia Autonomous Region, People’s Republic of China, our approach is to explore experiences that households with people with disabilities have had with a newly implemented rural health insurance reform. The introduction of this reform is significant as lack of insurance and high healthcare expenses are currently perceived as crucial to causing poverty in rural China. We show that people with disabilities have been able to access this new insurance. At the same time, as currently practised, the new insurance does not prevent poor households from sinking deeper into poverty when using healthcare services as healthcare expenses increase.

Keywords:

• poverty
• disability
• People’s Republic of China
• New Rural Cooperative Medical System
• healthcare services

Acknowledgements

We wish to acknowledge the contribution to the research project by Professor Zhao Tizun and Vice-General Secretary Feng Yanxia, both China Association of the Rehabilitation for Disabled Persons. We would also like to express our thanks to Director Yuan Wenying and Vice-Director Zhou Hailong of Chifeng Disabled Persons’ Federation of Inner Mongolia Autonomous Region along with the personnel of the disability association locally in Harqin for their assistance in order to implement the project. We are especially grateful to the families in Harqin for their participation in the interviewing. In addition, we would like to thank Inger Altern and Ellen Kristvik for productive suggestions to earlier drafts of this article, and to Camilla Hansen and the other colleagues at the Section for Medical Anthropology and Medical History, University of Oslo, for inspiring discussions. We would also like to thank the two anonymous reviewers for helpful comments. Finally, we wish to acknowledge the support of The Research Council of Norway (Poverty and Peace Program) for granting the funding for this research.

Notes

1. Wang is a pseudonym.

2. In detail, the disposable income per capita in a disabled person’s family in urban areas was 8578 Yuan (€926.4), which was only 54.4% of the national average in urban areas. In rural areas, the income was 4066 Yuan (€439), which was only 85.0% of the average (CDPF, Beijing University, and National Bureau of Statistics 2009). 100 Yuan is equivalent to €10.80 (22 July 2011).

3. Other new systems are the Minimum Living Allowance, the Medical Financial Assistance programme and a rural, voluntary pension scheme (OECD 2010).

4. Concerning rural–urban registration and other examples of rural–urban inequalities in China, see for example Whyte (2010).

5. On changes in the canji (‘disability’) policies in the history of the PRC, see Fjeld and Sagli (2011).

6. The government designates poor counties and then invests through government departments and state-owned banks (Park, Wang, and Wu 2002).

7. The total population of Chifeng is 4.4 million, and that of Harqin is 340,000.