Uyghur Farmers' Health Plan Leaves Many Poorly Covered

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A farmer harvests cotton in China's Xinjiang region in an undated photo.
A farmer harvests cotton in China's Xinjiang region in an undated photo.

A health insurance scheme set up to benefit rural residents of northwestern China’s Xinjiang region has left those it was intended to help barely covered, with many now facing large out-of-pocket costs for limited medical care, sources say.

Claims are never fully paid under the government-sponsored plan, under which applicants seek reimbursement by using  a “cooperative medical treatment card,” a farmer in Tokkuztara county in the Ili (in Chinese, Yili) Kazakh Autonomous Prefecture told RFA’s Uyghur Service.

“They do a lot of ‘reviews’ before they reimburse our medical bills,” the farmer, a young woman named Shehide, said.  “It often seems that local officials are eating the benefits.”

When Shehide’s mother, a heart patient, was sent home from a hospital when the costs of her care began to rise, her family found themselves forced to buy medicine outside the hospital, which did not have what they needed on hand, she said.

“And so we ended up paying more, even though a small amount was finally reimbursed.”

“Basically, the card is useless,” she said.

Limited options

Also speaking to RFA, the owners of two private pharmacies in Xinjiang’s Aksu (Akesu) prefecture confirmed the government-sponsored plan would not reimburse for medicines purchased at their stores.

“They cannot buy medicine here with the cooperative medical treatment card,” one owner said.

“If someone presents a government worker’s card, we can sell them the medicine they need, but the cooperative medical treatment card cannot be used at this store at all.”

“We can only use government worker’s cards here,” another pharmacist said. “Farmers can use their cards only at the hospital pharmacies.”

Rates of repayment for medical care also vary from place to place, one Uyghur farmer said, adding that the card itself costs 100 yuan (U.S.$15 approx.) per year to use.

“So if I have five people in my family, I must pay 500 yuan (U.S.$77 approx.) each year just to have the card,” he said.

“If we get treatment in a township hospital, we are reimbursed for 80 percent of our costs.  At the county level, we get less than that.”

“And if we are treated in [the regional capital] Urumqi, we get back only 40 to 45 percent,” said the man, whose son is being treated in a hospital in the capital.

“I have paid 30 thousand yuan (U.S.$4,638 approx.) out of my own pocket so far, and have not had any reimbursement yet,” he said.

Inadequate coverage

No repayments will be made on bill amounts above 15 thousand yuan (U.S.$2,319 approx.), though, an official in Aksu’s medical  treatment card management office said.

“Patients must first seek treatment, then we will reimburse,” the official said, speaking on condition of anonymity.

“Formerly, the government would cover 85 percent of their bill, but since July we have reimbursed at only 75 percent.”

“The total bill should never exceed 15 thousand yuan, though,” he said.

This amount allowed under the plan is inadequate to cover patients’ needs, said  Juret Obul, a Uyghur doctor now practicing in Fairfax, Virginia.

“The cooperative medical treatment card sounds like a good thing, but the amount allowed is really nothing.”

“This card really doesn’t help the farmers at all,” he said.

Reported by Kurban Niyaz for RFA’s Uyghur Service. Translated by Mamatjan Juman. Written in English by Richard Finney.





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