It is not easy for a nation as populous as China to establish a basic healthcare insurance system for everyone.

But it has been on the government's agenda since 1998 when healthcare insurance was introduced for employees in urban areas, the Ministry of Labor and Social Security said at a press conference yesterday.

Also, the healthcare insurance introduced on a trial basis last month for primary and high school students and the unemployed in 79 cities is the continuation of the State's efforts to realize the dream of providing every citizen with medical care security for serious diseases.

Subsidies from both the central and local governments will be at least 40 yuan (US$5.30) per person per year. It is hoped the system will cover all cities by 2010.

If the hope becomes a reality the basic healthcare system, including insurance for urban employees, rural cooperative healthcare for villagers and insurance for the unemployed and students, will cover all residents.

Research into how the new insurance would be introduced began two years ago. Preparations can never be too extensive when designing such a scheme. Any carelessness or slip might ruin an otherwise well-intentioned plan.

For example, the financial status of the urban unemployed must be taken into consideration in deciding the payment threshold. If it is too high, many might not be able to afford to join the insurance scheme. If it is too low, a lack of money will damage the effectiveness of the fund.

The pilot schemes being run in 79 cities will help the government identify and iron out any problems before rolling out the scheme nationwide.

One problem already identified concerns how elderly people living with a son or daughter will have their medical bills paid, when the system is based on their household registrations. Also, should the insurance include rural migrant workers who are based almost permanently in urban areas?

Sources from the labor and social security ministry said a project is under way to make it possible for people to have their medical bills reimbursed even if they are outside their household registration area.

It also said the government has plans to make firms buy medical insurance for the migrant rural workers they hire.

(China Daily August 16, 2007)