The evolution of health policy in China and internal migrants: Continuity, change, and current implementation challenges

Yunting Zheng,Marco Liverani,Ying Ji,Chun Chang

doi:10.1002/app5.294

Abstract

AbstractRural–urban migration is a defining feature of socio‐economic change in contemporary China. It is estimated that internal migrants in China account for 20% of its population of 1.39 billion, providing manpower to the expanding urban industries. Yet internal migrants have long faced barriers to accessing health and other social services in urban destinations, and the migration process may expose them to novel health risks and inequities. Based on the analysis of policy documents and associated material, this article reviews the historical development of health policy in China in relation to internal migrants, identifying elements of continuity and change in the policy agenda and the ways in which migrants have been framed in policy formulations. Against this background, remaining gaps in the current policy framework and implementation challenges are discussed.

Highlights

Internal migration has been a key driver of socio-economic and demographic change in China over the past four decades
Gaps remain in the ability of the health system in China to provide this population group with affordable care, especially those employed in the informal sector. We examine these developments in historical perspective, identifying elements of continuity and change in health policy statements related to internal migrants and associated implementation challenges
During Hu's tenure (2002–2012), an important policy move to achieve this goal was the institutionalisation of two voluntary health insurance schemes, financed by a combination of direct government subsidies and individual contributions: the New Rural Cooperative Medical Scheme (NRCMS), introduced in 2003 to revitalise the former rural health insurance based on collectivisation, and the Urban Residents Basic Medical Insurance (URBMI), introduced in 2007 to cover the non-working population in the cities, such as children and the elderly, as well as those employed in the informal sector

Summary

Introduction

Internal migration has been a key driver of socio-economic and demographic change in China over the past four decades. The National Family Planning Commission, the agency established in 1981 to implement the one-child policy, extended these provisions nationwide, requiring local authorities to promote and enforce birth control measures in migrant workers (doc-2 1991).

Results

Conclusion