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China’s Social Security System and its Reform (EMA) Prof. Dr, Chun Ding, Fudan University 2016-2017 H5301 • Basic knowledge • Overview of China’s social security system • Reform of China’s social security system • Problem, challenges and prospects Part 0. Basic Knowledge Part 1.Basics of China • • • • Total land area : 9.6 million sq. km Total sea area : 4.73 million sq. km Rank 3rd in the world , roughly equal with the United States Terrain descending from west to east Topographic map of China Heihe Area: 43% Population: 94% GDP: 96% Meters Tengchong Mountains : 33% Plateaus : 26% Basins : 19% Plains : 12% Hills : 10% Percentage of Different Topography of China Plains 12% Basins 19% Hills 10% Mountains 33% Plateaus 26% Source: National Bureau of Statistics: China Statistical Yearbook 2010 Natural Resources Reserves of many natural resources of China are ranked among the largest in the world. Due to a large population the per capita average share of natural resources are relatively low •Land resources • • • • • Cultivated Land : 13% Forests 20% Water area in land 2% Grassland 42% Others 23% •Mineral resources: • Total value of proven mineral resources: rank 3rd in the world • Per capita: less than ½ of the world average •Water resources: • Per capita: ¼ of the world average • Almost half of 670 cities in China are facing the problem of water shortage Demographic Situation • Population:1.37 bill. (Nov. 1st, 2010) • • • • • • • • • Mainland:1.33 bill. Hong Kong: 7 mill. Macau: 0.55 mill. Taiwan:23 mill. Population growth rate: 0.57% Birth rate: 13.14 births/1,000 population Death rate: 6.94 deaths/1,000 population Net migration rate: -0.4 migrant(s)/1,000 population Age & Gender structure (Mainland): • • • • 0-14 years: 16.6% 15-59 years: 70.14% 60years and over: 13.26% Male/Female: 105.2:100 China’s population pyramid Administrative divisions • 23 provinces : • Anhui, Fujian, Gansu, Guangdong, Guizhou, Hainan, Hebei, Heilongjiang, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shaanxi, Shandong, Shanxi, Sichuan, Taiwan, Yunnan, Zhejiang • 5 autonomous regions • Guangxi, Nei Mongol, Ningxia, Xinjiang, Xizang (Tibet) • 4 municipalities • Beijing, Chongqing, Shanghai, Tianjin • 2 special administrative regions • Hong Kong and Macau Financing, coverage, benefits Empty individual account problem Generation contract PAYG PAYE Social dumping, Ageing society Related Basic knowledge Social Contribution Beveredge and Bismarck Model Three –pillar-model Replacement Rate Individual saving Account Economic Developments since the Reform and Opening Up • 2nd biggest economy in the world (2011) • GDP: 7.3 trillion U.S. dollars • 50 times of its GDP in the year 1978 • Share of Chinese GDP in the World(1978-2011): • 1.8% - 10.4% • Average annual Growth rate of GDP (1978 -2011) • About 9.97% Source: World Databank of World Bank China's GDP (1978-2011) 50000 47156.4 45000 39798.3 40000 Billion RMB 35000 30000 25000 20000 15000 10000 5000 0 364.52 Source: National Bureau of Statistics: China Statistical Yearbook Four significant Changes • Marketlization: Economic transformation from central-planned system to market-oriented system has been largely completed • Globalization: China’s economy has been converted from isolated structure in the past to the opening system at present • Share of Chinese Foreign Trade in the world ( 0.79%-export & import,1978; 10.4%- export,9.5%-import,2011) Export volume rank 1ST, Import volume rank 2nd, (2011) • T • Urbanization: The pace of urbanization has been tremendously accelerated • 51.3% ratio of Urbanization,2011 (from 17.9% in 1978) • Industrialization: The process of industrialization speeded up • (Primary: Secondary: Tertiary in total GDP)28.2:47.9:23.9% - 10.2:46.8:43% (1978 – 2010) Great improvement of Chinese people's living standard • Ranking of China in terms of GNI per capita • Rank 175 in 188 (1978) Rank 115 in 214 (2011) • Per capita income • Disposable income of urban residents: 8.95 times (1978-2009) • Net income of rural residents: 8.61 times (1978-2009) • Engel's Coefficient: • 57.5% reduced to 36.3% (1978-2011) urban residents • 67.7% reduced to 40.4% (1978-2011) rural residents • Life-expectancy on average • 68 years - 73.5 years(1981-2011) • Average years of education • 8.64 years Source: National Bureau of Statistics: China Statistical Yearbook Growth of wages • Wages on average in 2011: • Private Sector: 24556 RMB, growth rate: 18.3% • Non-private Sector: 42452 RMB, growth rate: 14,3% • Changes of Standards for minimum wages: • 25 provinces has adjust the standard for minimum wages, the average growth rate of which reached 22% • The highest standard for minimum monthly wage: 1320RMB, in Shenzhen • The highest standard for minimum hourly wage: 13 RMB, in Beijing Problems faced by China’s Economy • Problems in long-term • Uneven benefit distribution, widened wealth gap • Excessive resources consumption, Deteriorating environment • Unsustainable economic growth-model Uneven benefit distribution, widened wealth gap • Imbalanced distribution of income and benefits • Gini Coefficient 0.24 - about 0.48 (1984 – 2008) • Gaps of income per capita between urban & rural: • Urban v.s. Rural 2.57 times (1978), 3.22 times(2005) • Gaps of income between rich & poor households: • 10% of households with highest-income v.s. 10% of households with lowest-income 8.63 times (2009 in urban) • Gaps between different regions: • In 2009, the ratio of GDP per capita :Zhejiang (coastal province) : Gansu (barren hinterland Province) 3.45 times • Social instability has been gradually built up : • nearly 90,000 collective upheavals in 2009 • Excessive resources consumption,Deteriorating environment Created 8%GDP of the world. Consumed: energy 18%,steel 44%,cement 53% of the world (2009) • Land desertification: Desertification governance Unsustainable Growth-model 30 years rapid growth of China’s economy was mainly driven by investment and export •Decreased efficiency of government investment •High dependency on foreign trade (Imp.&Exp./GDP) • Rate:59.2% (2008), 12.5% ( 1980). • Increased trade friction, trade protectionism •Pressure on RMB appreciation • Trade surplus: US$18.3 bill. (2010) • Exchange rate of RMB: USD: 25% appreciated (2005 till now) Solution • Upgrading!? • There are a lot of difficulties in industrial upgrading • Low end of the industrial chain • Low private consumption • Imperfect social security system • Less-qualified labor force • Education, R&D • The danger from mass-unemployment • Urbanization is a feasible solution Part I. Overview of China’s Social Security System Structure of China’s social security system Social Insurance Social Welfare Special Care & Placement Social Relief Housing Security Social Security in Rural Areas •Old-age Insurance •Medical Insurance •Unemployment Insurance •Insurance for Work-related Injuries •Maternity Insurance •social welfare homes •old-age homes •sanatoriums •children’s welfare homes •the Minimum Living Standard security system for Urban Residents •Natural Disaster Relief •Relief for Urban Vagrants & Beggars •Social Mutual Help •Rural pension Insurance System •Rural Cooperative Medical Service •The Minimum Living Standard security system for rural Residents • Evolution Process of China’s Social Security System • 3 Stages: • 1949 -- 1978: traditional social security System in the Central-planned Economic System • 1978 -- 2002: Pioneering Experiments and Reform under Transition from Central-planned Economy to Market-oriented Economy • From 2003 -- now: promotion for establishment of an unified nationwide social security system with universal coverage Institutional Arrangements of traditional Medical Insurance System Urban Area Rural Area Scheme Government Insurance Scheme (GIS) Labor Insurance Scheme (LIS) Rural Cooperative medical scheme (RCMS) Financing Governmental financial agencies at all levels Enterprise welfare fund Collective investment, joint investment by collectives and individuals, and individual investment Eligibility / Beneficiaries Working staff members of non-profit institutions, students and retirees Working staff members of stateowned and collective owned enterprises, and their spouses, retirees 97% Peasants joined voluntarily Achievement and Defects of HCS in Central-Planned Economic System • Began in the early 1950s • Achievements • 1. Elementary Health Insurance System (80-85% in mid 1970s) • 2. Elementary Health care delivery system (non-profit, prevention before treatment) • 3. Epidemic prevention service (e.g. extermination of smallpox in 1960, 10 years earlier than its in the whole world) • 4. Medical Resources, 2% of the world • Securing the Health of 22% of the world population The infant fatality rate, 200‰ 1949 --33.2‰ 2004 the incidence of acute epidemics, 20,000/100,000 early 1950s ---- 194.8/ 100,000 late 1990s • life expectancy 35 years 1949-------- 68 years 1981 • • Part II Reform of China’s Social security system Factors led to the reform •Economic reform go ahead! •Decline of coverage rate some former ensured employees in SOE switched their jobs to the private enterprises ,joint ventures, farmers etc., lost safety net •Funding problem by economic Transition government and SOE were unable to fully finance the system like before •Obstruction on free mobility of labor force and fair competition of enterprises different ownership separate social security system and different burden of different enterprises •Ageing problem Ageing society since 1999,(11% above 60) Calculated at the price level of 1998, the medical expense will be increased by 26.4% due to the acceleration of aging of population. •Great Demand for social security system from rapid economic growth and condition for sustainable economic growth Great Demand occurs from general Public for a reasonable and efficient social security system due to institutional Transformation, Economic Growth, and Wealth Accumulation Process of Reform and Reconstruction Time Content 1984 Pension insurance system 1986 urban unemployment insurance system 1994 maternity insurance system 1996 employment injury insurance system 1998 Housing security system 1998 medical insurance system reforms for urban employees 1999 the Minimum Living Standard Security System 2003 New Rural Cooperative Medical Insurance 2007 Rural Minimum Living Standard Security program 2007 Urban Residents Basic Medical Insurance 2009 New Medical Insurance system 2009 New Rural Old-age Insurance System 2011 Social Insurance Law of the P.R.C. 2011 New Urban Social Old-age Insurance System 2013 Critical illness insurance for urban and rural residents 2014 Rural and urban old-age insurance schemes emerged into one 2016 the integration of urban and rural residents basic medical insurance • Old-age Insurance • Old-age insurance for urban employees • Old-age insurance for urban residents • New old-age insurance for rural residents • Medical Insurance • Employees medical insurance • Medical insurance for urban residents • New cooperative medical insurance for rural residents • Critical illness insurance for urban and rural residents • the integration of urban and rural residents basic medical insurance • Unemployment Insurance • Insurance for Work-related Injuries • Maternity Insurance Ageing Population in China • • • • 1999 Ageing society Average Life expectancy ,72(a) , 70(m)、74(f)。 Three phases 2001—2020 ageing society 2021—2050 speeding up 2051—2100 stable。 China’s population pyramid Demographic structure 1953 1964 1982 1990 % 2000 2005 2010 0-14 36.27 40.30 33.59 27.69 22.90 20.77 16.60 15-59 56.4 52.67 58.77 63.74 66.64 68.70 61.27 60 and over 7.32 6.07 7.63 7.63 65 and over 4.41 3.53 4.91 5.57 Source: China Statistics Yearbook 10.46 11.03 13.26 7.10 7.69 8.87 • Demographic Structure in Forecast (%) 2000 2010 2020 2030 2040 2050 0-14 24.84 20.25 18.83 17.17 16.21 16.09 15-59 65.07 67.49 64.34 59.23 56.22 53.93 60 and over 10.10 12.26 16.83 23.60 27.57 29.95 80 and over 0.89 1.33 1.85 2.71 4.43 7.00 100 and over 0.009 0.002 0.0045 0.0092 0.0172 0.0338 Aging Problem year Workers’ population to retirees’ 1978 30:1 1983 10:1 1990 6:1 2025 3:1 Institutional arrangement of old age insurance system for urban employees Financing Employer Pension Payments Social Pooling Fund 20% of average monthly wage Private Saving Account 1/120(139) accumulation in individual accounts 20% Employee 8% Institutional Arrangement of urban Health Care Reform 1998 Reimbursement Financing Self payment 6%*70% Employer 6% Social Pooling Fund + Self payment Co-pay/Co-insurance 4.2% 6%*30% Employee 2% Ceiling (4 (6)times of annual average salary of local working staff members) Private Saving Account 3.8% + Out of Pocket Deductible (10% of annual average salary of local working staff members) Institutional Arrangement of Rural Health Care Reform 2003 New Rural Cooperative Medical Insurance since 2003 Financing Central Government Local Government 10(20) yuan 10(20) yuan 10 yuan Peasant each Beneficiary Cooperative Health Care Fund Catastrophic Disease Insurance Failure of Urban Health Care Reform 1998 1. Rapid Increase of Health Expenditure (HE) 1. Annual growth rate of HE: 15-22% vs. annual growth rate of GDP:9.8% 2. Increasing Proportion of out-of-pocket payment: 20%-52% (1980-2005) VS. Decreasing governmental input: 37%-17% 2. Inequality 1. Low Health Care Coverage <50% for urban,90%for rural 2. rare Access to Health Care Services 3. Unreasonable and inefficient allocation of related resources 1. Unreasonable Input of Health Resources (urban 65.1%;rural 34.9%) 2. Big gap between different regions (10.3 Beijing: 2.7 Yunnan doctors per 1000) 3. Dual structure: urban areas vs. rural areas (urban 6.5 : 0.8 rural beds per 1000) Rapid increase of health care expenditure (1978-2005) NHE per capita NHE as % of GDP 700 6 600 5 500 3 300 2 200 1 100 0 0 19 78 19 79 19 80 19 81 19 82 19 83 19 84 19 85 19 86 19 87 19 88 19 89 19 90 19 91 19 92 19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 % 400 Source: Health Statistic Yearbook. The statistic method of GDP in 2004 and 2005 was different. Yuan 4 Urban Health Care Coverage 30.4% 50.4% 4.0% 4.6% 5.6% Social Medical Insurance(including BMI) Government Insurance Scheme Labor Insurance Scheme Commercial Insurance Without any Insurance Source: The Report on the 3rd National Health Service investigation and analysis Reasons to the Failure of urban Health Care Reform 1998 1.The Counter-Compelling Mechanism Brought by Economy Reform on Health Care Reform Economy reform-weakened gov. finance, shrinking of coverage , collapse of traditional Rural Cooperative Medical Scheme … 2. Weakened Role of Government in Health Care, especially Its Excessive BurdenShifting and Inadequate Functional Operation of Governmental Financial Agencies governmental( 32.16%-17.9%), (1978-2005) individuals (20.43%-52.2%) (1978-2005) 3. Lack of Real Market-Oriented Reform in Health Care Delivery System, and Lack of Parallel Coordinated Reforms on such Three Aspects of Health Care, Medical Insurance, Pharmaceuticals The market-oriented reform of health care expenditure is checked by the bottleneck of central-planned medical service income. Health Expenditure of China (1980-2005) Year 1980 1985 1990 1995 2000 2004 2005 Total Expenditure of Health Care 100 million yuan 143.2 279 747.4 2155.1 4586.6 7590.3 8659.9 Health Care Expenditure Paid by Government% 36.2 38.6 25.1 18 15.5 17 17.9 Health Care Expenditure Paid by Social Pooling% 42.6 33 39.2 35.6 25.6 29.3 29.9 Health Care Expenditure Paid by Individuals% 21.2 28.5 35.7 46.4 59 53.6 52.2 Average Health Care Expenditure Per Capita (yuan) 14.5 26.4 65.4 177.9 361.9 583.9 662.3 The Proportion of Total Medical Expenditure to GDP% 3.17 3.11 4.01 3.69 5.13 5.55 4.73 Source: China Statistics 2006 Comparison between China and Some of Countries of the World on Major Indexes of Health Care Expenditures (%) Expenditure of Health care/GDP Public Health Care Expenditure/Total Expenditure on Health Care Public Health Care Expenditure/Gover nmental Expenditure Medical Insurance Expenditure/Pubic Expenditure 1997 2003 1997 2003 1997 2003 1997 2003 China 4.2 5.6 39.4 36.2 13.6 9.7 87 53.4 Argentina 8 8.9 55.2 48.6 20.1 14.7 60.2 56.8 Brazil 6.5 7.6 40.3 45.3 9.7 10.3 0 0 India 5.5 4.8 15.3 24.8 4.7 3.9 0 4.2 France 9.4 10.1 76.1 76.3 13.5 14.2 96.8 96.7 Germany 10.5 11.1 76.6 78.2 16.7 17.6 90.7 87.4 Japan 7.4 7.9 79.5 81 16.5 16.8 89 80.5 Britain 6.7 8 83.7 85.7 13.7 15.8 11.6 0 U.S. 13 15.2 45.5 44.6 17.3 18.5 31.9 28.4 Source: World Health Statistics 2006, WHO. Decreasing share of govt. exp. and increasing share of out-of-pocket % of total health expenditure 70 Govt. Exp. 60 Soc. Exp. 50 52.2 Out-of-Pocket 40 30 29.9 20 17.9 10 0 1980 1990 1995 2000 2002 2003 Source: Health Statistic Yearbook, 2006 2004 2005 Healthcare System Financing Drugs & Equipment Health Personnel Healthcare Delivery Management & Regulation Debates on Choices of Models of Health Care System • Reason to the failure: Market Failure or Government Failure? • Which model can we choose? Beveridge? Bismarck? American ? new Concept of recent health care Reform • by 2020 a fundamental health care system covering the whole population of China will have been established in our country. • A fundamental national medicine registration system will be roughly established, • Strengthen a health service system on a basic level • Promote the basic public health service gradually toward equalization. • Advance the public hospital pilot reform. Time line of China’s healthcare reform t Text 2003 2006 2007 2009 Institutional Arrangement of Health Care Reform 2009 • Promote the basic public health service gradually toward equalization (1) The schemes of basic public health services cover all the rural and urban residents. (2) An official list of categories of basic public health services established. 10 categories of basic public health services provided to all residents free of charge. More than 81 million people over age 65 had health checks (3) Constructed a nationally unified system of archives of the health conditions of residents. Over 50% Chinese health information are recorded in this system at the end of 2011 (4) All the financial resources used to guarantee the public health services provided by government through its budget. Per capita allowance to basic public health services : 15 yuan in 2009, 25 yuan in 2011 New Rural Co-operative medical system In October 2002, China clearly put forward that the governments should guide farmers to establish a new type of rural cooperative medical care system. In January 2003, China explicitly put forward that the system should be organized, guided and supported by the government. And it should be participated voluntarily by rural residents. It will be a system which needs the individual, collective and government multilateral capital. New Rural Co-operative medical system In 2009, China made important strategic deployment which means that we will deepen reform of the medical and health system. And meanwhile, we made sure that the New Rural Co-operative medical system will be the rural basic medical security system. In 2015, the Health development planning commission and the ministry of finance made the decision that per capita subsidies standards of the system should increase 60 yuan from the basis in 2014, reaching 380 yuan. The problems in New Rural Co-operative medical system • Many people are working outside and don’t have urban health insurance, so they are only in the New Rural Co-operative medical system. But the problem is, they should join in the system in the place of their domicile. They can’t do that in the place where they live. It is very inconvenient. • Most of the costs in terms of reimbursement are outpatient expenses. Hence, the participants cannot submit an expense account in residence, even in the place of domicile. And for the hospitalization expenses, if it is not a big number, it will not worth going back to get the money. • The system may also enlarge the gap between the rich and the poor. For poor families, even part of the expenses can be afforded by the government, they still can’t pay the surplus. But things are different for the rich families. This provides them with the real benefits. China’s Healthcare Reform • Chinese President Hu Jintao Political Bureau of the Central Comm Oct 23, 2006 • “The goal is for everyone to enjoy basic health care services” • Government has responsibility to build a safe, effective, convenient and inexpensive health care network covering both urban and rural residents China’s Healthcare Reform Party secretary xi Jinping hosted Central Leading Group for Comprehensively Deepening Reforms ’s 19th meeting on December 9th,2015. And in the meeting, he put forward that we should integrate urban residents basic medical insurance and the new rural co-operative medical system, and make the establishment of a unified basic medical insurance system for urban and rural residents. The State Council issued the documents about the integration of urban and rural residents basic medical insurance on January 3rd ,2016. The integration of urban and rural residents basic medical insurance • Integration of basic system policy 1. Unified coverage 2. Unified financing policy 3. Unified security treatment 4. Unified health insurance directory 5. Unified fixed point management 6. Unified fund management Critical illness insurance program since 2012 China in 2012 announced a decision to expand the coverage of the country's healthcare insurance system to include the treatment of critical illnesses, aiming to prevent patients from being reduced to poverty by necessary healthcare costs. The critical illness insurance means that people can submit an expense account again after they get reimbursed on the basis of the medical insurance. It should be no less than 50%. Official Registered Unemployment(1978-2010) 10 9.08 9 8 7 6 5 4.1 4 3 2 1 0 Official Registered Unemployment Rate(%) Official Registered Unemployment Workers(million) Source: Labor and Social Security Yearbook Three Unemployment Peak in China Unemployment Peak 1 —1979-1980 Educated youth been sent to rural areas (zhiqing) 15 million, by 1979 returned to urban area Unemployment Peak 2 —the end of 1990s SOEs Reform laid-off worker more than 21 million, From 1999 to 2005 Unemployment Peak 3 —2002-present urbanization process, College enrollment increased dramatically 200 million migrants, 1.05 m,1998---6.7m,2011 Unemployment Insurance • Requirements for applying for unemployment pension: • (1) participate in the unemployment insurance program keep paying premium more than one year; • (2) out of work unwillingly; • (3)fill in unemployment registration, been looking for job actively Unemployment Insurance Premium enterprises and institutions employees 2% of total wage bill 1% of personal wages Work-related injury Insurance • Premium (% of the total wage bill of the employers) • • • Low level risk industry (0.5%), Medium level risk industry (1%), High level risk industry (2%) • Benefits • • • • • • Work-related Injury Medical Treatment Work-related Injury Allowance Disability Allowance Lump-sum Disability Subsidy Dependents Benefits Lump-sum Death Subsidy Work Injury Insurance Contributors at Year-end (1 million persons) 180.0 160.0 140.0 120.0 100.0 80.0 60.0 40.0 20.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Contributors at Year-end((1 million persons) 2005 2006 2007 2008 2009 2010 Social Insurance Premium & payment System Premium Payment Pension Insurance Unemployment Insurance Medical Insurance Workrelated Injury Insurance employees 8% enterprises 20% others 18% (Of the wage) employees 1% enterprises 2% (of the wage) Employees 2% Enterprises 6% (of the wage) Enterprises all Enterprises all (Less than1% of the wage) 1-5years 12months 5-10years 18 months 10-years 24 months Outpatient treatment fees Personal account hospitalization expenses social pool fund Medical expenditures; Injury and disability subsidy; Funeral subsidy 90days’ allowance, Original wages and positions, Medical expenses 20% of average monthly wage + 1/120 accumulation in individual accounts Maternity Insurance Institutional Arrangement of Housing Security System publicly accumulated housing funds Contribution Rate: 14% - Shanghai Housing Security System the system of generally affordable and functional housing the low-rent housing system Housing Security • Opinions on Resolving Housing Difficulties of Low-income Families in Urban Area. 2007 • Indemnificatory apartments • Low-rent housing, Affordable housing, Public rental housing • Indemnificatory apartments and Shanty areas rebuild apartments, 12 million suite constructed, 2008-2011 • Subsidy fund from central public finance • 7.2 billion,2007------171.3 billion, 2011, • increased by 121% per year Achievements social security expense of the fiscal Increased by 19.4% annually from budget 2003 urban basic old-age insurance 284 million urban basic health care insurance 473 million unemployment insurance Work-related injury insurance 143 million 177 million Maternity insurance 139 million Minimum subsistence guarantee 23.34 million urban residents 42.91 million rural residents Work-related injury insurance urban health care insurance Over 68 million peasant workers over 46 million peasant workers New rural cooperative health care 97.5% of the total rural population insurance The Coverage of Main Social Insurance Schemes(2014) • • Medical Insurance (including Urban Employees Basic Medical Insurance, Urban Residents Basic Medical Insurance, New Rural Cooperative Medical Insurance) over 95%,2014 • • New Rural Cooperative Medical Insurance 98.7%,2014 • • Old-Age Insurance 843 million population • • Work-related Injury Insurance 206 million • • Unemployment Insurance 170 million • • Social Relief • Minimum Living Standard security system for Urban Residents • • • 18.8 million persons, 2014 Security standard: 148 RMB, 2002------450RMB,2015 Monthly subsidy: 43.9 RMB per person, 2002------303 RMB per person, 2015 • Minimum Living Standard security system for Rural Residents • • • 15.93 million persons,2006------52.09 million persons, 2014 Security standard: 840 RMB, 2007- -----3182RMB,2015 Monthly subsidy: 38.8 RMB per person, 2007------145 RMB per person, 2015 • Five-Guarantees Subsistence Program in the Rural Areas • • • • food, clothing, housing, medical care, and burial expenses concentrated subsistence standard: 1608 RMB,2006------5883RMB, 2015 scattered subsistence standard: 1224.5 RMB,2006------4388RMB, 2015 2.13 million persons,2002------5.30 million, 2014 • Medical relief system for urban and rural residents • Relief for Urban Vagrants & Beggars • Central government provided 39.55 billion RMB to Social Relief Program, 2014 Anti-Poverty in rural areas impoverished population in rural areas (1978-2007) year 1978 1990 1995 2000 2001 2003 2005 2006 2007 poverty threshold (RMB) 100 300 530 625 630 637 683 693 785 impoverished population 250.0m 85.0m 65.4m 32.09m 29.27m 29.0m 23.65m 21.48m 14.79m Source:China Statistics Yearbook 2008 percentage of impoverished population(%) 30.7 9.4 7.1 3.5 3.2 3.1 2.5 2.3 1.6 impoverished population in rural areas (2008-2011) year 2008 2009 2010 2011 poverty threshold (RMB) 1067 1196 1274 2300(6.3/day) impoverished population 40.07m 35.97m 26.88m 128.0m percentage of impoverished population(%) 4.2 3.8 2.8 13.4 International poverty line: $1.25 per day at 2005 purchasing-power parity (PPP), World Bank,2008 Source: China Statistics Yearbook Service Delivery System of China’s Social Security System Service Access Citizen Service Centre Operation Process Institution Information Platform Function Collection Process of Insurance Participant’s Information Social Security Bureau at Three level: NationProvince-Municipality or County Platform of Insurance Participant’s Account Information Interpretation of Social Security Policy Platform of Social Security Mutual Funds Information Finance Security Platform of Policy Information IT System Platform of Information Sharing and Exchange Internal Management Three Functional Social Security Module: Front-end Service Delivery Service; Middle-end Process Management; Backend Supervision Service Administrative Institution of China’s Social Security System Ministry of Human Resource and Social Security Old-Age Insurance Unemployment Insurance Urban Health Insurance ork-related Injury Insurance Maternity Insurance Ministry of Civil Affairs Ministry of Health Social Relief Social Welfare Urban and Rural Medical Relief Rural Cooperative Medical Insurance Part III Problem, challenges and prospects of China’s Social security system Problems in general • Limited coverage • Inequality • different benefits -level among different social group and regions, • heavily focused on the formal sector of urban China. • A high degree of fragmentation. • contribution rates vary across municipalities; • risk pooling remains at the sub-provincial level in most cases; • portability of benefits is very limited (lack of national unified system). • The problem in financing: • deficit of the fund, • heavy burdens on the employers (29.8%+) Problems need for further reforms • 1. to reform the investment and management system of social security fund, improve the rate of return on fund investment. • 2. to solve the problem of over huge payment gap between employees of public sector and private sector. • 3. to enhance the support capacity of social security fund, expand capital sources of the fund, meeting with the challenge of aging problem. • 4. to build up a national unified social security management system, supporting the accounts transfer inter-province. Challenges • Rapid ageing process of the population (funding) will put more pressure on the old-age pension and medical care expenditure • The progress of urbanization and industrialization (coverage) will make the establishment and improvement of a social security system covering both urban and rural areas more urgent • Employment forms become more diversified (transferable). More employees in nSOEs sector and people employed in a flexible manner should be covered by the social insurance system • Pressure from Globalization (cost containment) Prospect • We should institute a complete, multi-tiered and sustainable system for providing basic social security for both the urban and rural population, with emphasis on making the system more equitable and sustainable and ensuring the smooth transfer of social security accounts between localities. • We should reform and improve the social insurance system for enterprises as well as government bodies and public institutions, integrate the basic old-age insurance and basic medical insurance systems for non-working urban residents and the rural population, provide sufficient funding for personal accounts for old-age insurance in a phased way, place basic pensions under unified national planning, and establish mechanisms for setting standards on social security benefits and regularly adjusting them that give due consideration to the interests of people from all walks of life. • We should widen channels for raising money for social security funds, introduce a system to manage investment operations of social insurance funds, and ensure that these funds are safe and appreciate over time. • We should improve the social assistance system and the social welfare system, support the development of charities, and ensure preferential treatment to entitled groups. • We should put in place a housing system that combines market supply and government support, strengthen construction and management of low-income housing, and better meet poor families' basic housing needs. • We should adhere to the basic state policy of gender equality and protect the legitimate rights and interests of women and children. • We should actively address population aging and vigorously develop old-age services. • We should improve the social security and service systems for the disabled and effectively protect their rights and interests. • We should improve the mechanism for supervising the work of social security agencies and make social security services more convenient and efficient. (Selected from the Report to the Eighteenth National Congress of the Communist Party of China) Thank you for your attention! Q&A