III. Health and Medical Care for the Aged

Improving medical care and service for the aged and enhancing their health are an important part of the efforts for the overall improvement of the people's health and quality of life in an ageing society. The Chinese government pays great attention to medical care for senior citizens in both urban and rural areas by improving medical and health services for them so as to meet their basic medical needs and improve their mental and physical health.

Strengthening Medical Care for the Aged in Urban and Rural Areas
The state has established a basic medical insurance system which combines the unified planning program with individual accounts for urban employees. Under this system, retirees do not have to pay the basic insurance premiums, and they are given appropriate consideration in the ratio of medical costs paid between what is put into their individual accounts by their former employers and the part they have to pay personally. The general practice now is that large amounts for the medical costs for elderly people's common and chronic diseases are covered by the funds under the unified planning program, thus reducing the percentage paid by the individual retirees. By the end of 2005, retirees covered by the basic medical insurance in China had reached 37.61 million.

The state has taken supplementary medical care measures to reduce the burden of medical costs for the elderly. The state has set up a medical subsidy program for civil servants, and such expenditure, including the part for retirees, is covered by the state revenue. The government encourages the establishment of a subsidy system to cover hefty medical costs throughout the country. The fund collected from individual or enterprise payments will be used to cover medical costs in excess of the maximum coverage under the unified planning program for employees and retirees who suffer from major, serious or chronic diseases.

Where conditions permit, enterprises have set up a supplementary medical insurance system to cover medical costs in excess of the maximum coverage under the basic medical insurance. The Chinese government is exploring ways to set up a social medical aid system in cities by pooling medical-aid funds from many channels, such as state revenue allocations, public lottery welfare funds and public donations, to subsidize the medical costs of people in dire need. By the end of 2005, experimental work had been conducted in 1,119 counties (cities, districts, banners), providing medical aid in 1.633 million cases.

Experimental work began in 2003 to set up a new type of rural cooperative medical system by pooling funds from individual payments, collective support and government subsidies. By the end of June 2006, such experimental work had been extended to 1,399 counties (cities, districts, banners), covering 495 million rural dwellers. Up to 396 million farmers, and over 73 percent of the elderly people in the experimental areas, had participated in this new type of rural cooperative medical system. A total of 14.412 billion yuan had been paid in 282 million cases as subsidies to farmers covered by the new type of rural cooperative medical system.

The central government requires local governments to give appropriate preferential treatment to people over the age of 70 participating in the new type of rural cooperative medical system to meet their special needs. A rural medical aid system has been established, with funds from government appropriations and public donations to help the elderly covered by the "five guarantees" system and poor farmers to join the new type of rural cooperative medical system. The medical aid system provides certain subsidies to poor farmers whose high medical costs for serious diseases have affected their basic family life, and has to a certain degree alleviated the basic medical burdens on the aged. So far the rural medical aid system has been set up in all of the 31 provinces, autonomous regions and municipalities directly under the central government. In 2005, a total of 1.08 billion yuan of medical aid subsidy was given to farmers in 11.12 million cases.

Special activities to provide the aged with dedicated medical aid and healing aid are going full steam ahead in China. The National Development Outline for the Disabled and the Action for Helping Seniors to Regain Their Eyesight, conducted mostly in the western areas, have given operations to about six million elderly people in remote areas suffering from cataracts, and helped poor and disabled seniors to recover or regain physical functions by providing artificial limbs or hearing aids for free.

Developing Medical and Health Services for the Aged
The state has strengthened the planning and leadership of medical and health work for seniors. The Chinese government has formulated and implemented the Plan for Medical and Health Work for Seniors in the Eighth Five-Year Plan Period (1991-1995), issued policy documents twice on improving medical and health work for seniors, including work in a series of health development plans such as the Outline for National Health Education and Health Improvement Work (2005-2010), Outline for the Development of China's Nursing Work (2005-2010) and Plan for China's Mental Health Work (2002-2010). The National Health Work for Seniors Leading Group and the Experts Consultative Committee for Health Work for Seniors have been set up to strengthen the guidance, coordination and scientific decision-making in this regard.

The state encourages large- and medium-sized medical institutions, where conditions permit, to open special departments or outpatient departments for senile diseases to provide specialized services to seniors. The establishment of medical service institutions according to regional health plans is also encouraged to help prevent and treat senile diseases, provide healing service for the aged and hospice care. Priority and preferential treatment for people over the age of 70 are generally provided in Chinese medical institutions in terms of registration, treatment, obtaining medicine and hospitalization. The Outline for National Economic and Social Development in the 11th Five-Year Plan Period issued by the government in 2006 included the Nursing with Care Project and speeding up the development of nursing facilities for elderly patients and the disabled as key tasks.

The establishment of an urban community health service system has been speeded up nationwide, with emphasis on medical and health work for the aged, so as to provide safe, efficient, convenient and economical health services to the elderly. Grassroots medical institutions all over the country are encouraged to convert into community health service institutions, and to provide health care, medical treatment, nursing and healing services for the aged.

By the end of 2005, over 15,000 community health service centers had been set up in Chinese cities, and urban community health services were available in 95 percent of the cities at or above the prefectural level, and in 86 percent of the districts under municipal jurisdiction and the county-level cities. With visiting and taking care of patients at home, daily care and hospice care provided by grassroots medical institutions according to the special needs of the elderly, their health problems can be basically solved within the community.

In consideration of health and physical characteristics of the aged, the Chinese government has made positive efforts in organizing hygiene and health care publicity work. Radio, TV, newspapers and community bulletin boards are all used to publicize common knowledge of how to keep fit and healthy in old age. Hospitals at various levels provide regular health lectures throughout the year to local communities, providing health advice to those suffering from chronic diseases.

The state has set the standard for healthy seniors, and organized national public appraisals of healthy seniors as a way to promote a scientific and healthy lifestyle. The "three-level prevention and treatment work" (of heart, brain and blood diseases as well as diabetes and other chronic diseases) is being stressed, and the prevention and treatment guidance and management plan for high blood pressure and diabetes has been formulated and gradually promoted to facilitate the early discovery, diagnosis and treatment of chronic diseases related to old age. Starting in 1991, the Chinese government began to include the prevention and treatment of senile diseases in the state scientific and technological plan. So far, more than 50 institutions in the country are engaged in research to prevent and treat senile diseases.

Promoting Mass Sports and Fitness Exercises among Elderly People
The Chinese government promotes mass sports and fitness exercises among elderly people with an aim to improve their physique and health. By the end of 2005, all counties and higher administrative units, 70 percent of urban communities and 50 percent of townships in rural areas had established sports associations for seniors, which are strengthening organization work and guidance for the mass sports activities of the aged. In recent years, the state initiated the National Fitness Project, which helps to set up public sports and fitness grounds and facilities, and to provide space for elderly people to do physical exercises.

At present, there are over 30,000 such sports grounds throughout the country. Since 2001, the "Millions of Seniors' Fitness Exercise Activities" organized in China have attracted more and more senior participants, so it is estimated that there are now more than 58 million elderly people doing regular sports and fitness exercises in China.