In the past,  rural communes and urban work units provided social benefits (health care, pensions, welfare)
New Policies:
    -  rural communes have collapsed, can't provide health services
    - Urban work units are being restructured into business enterprises. Won't maintain clinics
    - Special factories for handicapped have closed.
    - Emphasis on economic investment
Results:
    - Public health and welfare services are cut down to the bone, general services are marketized.
        problems:
           236-schistosomiasis.htm
            Aids
            SARS

    - New system is very inegalitarian, with highly selective targetting;
            does provide a partial safety net in urban areas.
      Follow this link for an excellent article by Yuanli Liu:
           http://www.scielosp.org/scielo.php?pid=S0042-96862004000700011&script=sci_arttext&tlng=en

Changing dependency ratios: number of older people increases; low birth rates mean fewer workers to support them
Urban work units have special problems:  Many factories established in 1950s, so retirements begin in 1980s, now old factories have very high welfare burdens, can't compete with new enterprises.  Plus, how to deal with layoffs (xia gang) of many workers.
   China admits its old pension program is empty (Beijing Review)
China is developing a new Social Security system, with payments from business, worker, and locality.  Not all businesses and localities can pay their share:

Policy is:

• officials, regular factory workers -- receive health insurance (with co-pays) and pension coverage
• laid off workers -- continue benefits for 2 years, training and help in finding new job.
• welfare for working age people.  Generally limited to people with serious disabilities.
• officials, factory worker retirees -- get social security from government offices, health insurance often in special locations (with co-pays)
• rural residents - "self" insured (i.e. no insurance, rely on help from friends and relatives)
•  fee for service at rural clinics, some public, most private
• a few rich rural localities are experimenting with socialized social security insurance
• rural residents migrating to cities -- same as rural residents; are supposed to buy insurance (with help from employer) but this probably is uncommon.  Insurance is costly, and people don't like insurance (don't want to help others, don't trust insurance agent), don't want to pay for what used to be free

Family Planning
    In practice many rural residents have 2-3+ children.  Policy of 1 child isn't being enforced. data
    preference for boys is still strong (BR article)

Poverty Relief: it is hard to have targeted programs.  Money goes to areas, and very poor don't get much

Migration.  Does help the poor, but the poor migrants to cities have a very fragile status.
 
 

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