Retirees In China Protest Health Insurance Changes

© Reuters Protesters gathered outside Zhongshan Park on Wednesday to protest changes to medical services in Wuhan, according to this social media video obtained by Reuters.

Protests by Chinese retirees against health insurance changes that cut payments for drugs and outpatient care have highlighted pressure from the Chinese Communist Party to provide better social services to a rapidly aging population despite a large "void" in local government coffers. Problems with ".covid".

On a rainy evening last week, hundreds of elderly people gathered outside the city hall in the central Chinese city of Wuhan to protest changes to the government's health insurance system, including cutting monthly drug requirements by a third.

Huddled under umbrellas and guarded by police in blue raincoats, a peaceful crowd sang the revolutionary anthem "The International" and chanted slogans demanding an explanation. The agitators said they would hold a second mass protest within a week if there was no solution.

As ordered, they filled Zhongshan Central Park and surrounding streets on Wednesday, with a second group gathering a few blocks away from Wuhan Union Hospital.

This time also the authorities reacted strongly. To reduce congestion, the city's subway cars did not stop at the next station. The video shows matches being delayed as police try to control the protests. Some tried to cross the barricade to avoid the fight, but were pushed back by men in uniform.

As the conflict escalated in Wuhan, another protest broke out in Dalian, a city of 7 million on China's northeast coast, with hundreds of elderly people wearing winter jackets taking to the square to protest the same changes.

The wave of discontent over the social reforms comes three months after Chinese leader Xi Jinping faced widespread social unrest over his sweeping coronavirus policies, which disrupted daily life and hurt businesses. After a while the group suddenly changed. Infections increased, hospitals and crematoriums collapsed.

Unlike November's unusually large and politically motivated protests, strange protests like this week's in Wuhan and Dalian are commonplace in China, even as Xi leans toward stability. Changes to pensions, education, housing and other basic social programs often echo when people demand protection of their rights.

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But events are putting pressure on the Communist Party as the nation faces a new economic reality that promises much better for the Chinese people. Decades of incredible growth have passed, but Xi has partly justified his unorthodox third term by promising to return to the party's egalitarian roots to advance the central political agenda of "common prosperity" for the masses.

Such ambitious adjustments cannot be cheap and easy, and Xi must do so at a time of growing economic headwinds, including a battered housing market, weak consumption and a declining population.

Also, mass testing, quarantines and lockdowns have forced local governments, already strapped for cash, to look for ways to cut costs. Although the health insurance reform is long overdue, pensioners complain that they have not been consulted about the changes and have not been helped to adapt to the new system.

© Ng Han Guan/AP Protests against the Forty Measures spread across China late last year. (Ng Han Guan/AP)

The reforms, announced in 2020, are aimed at easing pressure on state insurance funds, which some experts believe will run out within a decade due to an aging population. The idea was to focus on primary health care by reducing private accounts available for out-of-hospital services and medicines, and increasing funding from the central account for hospital primary care. Although the change is a national effort, the exact method will be determined locally.

Aidan Chow, a researcher at the China Labor Bulletin, a non-governmental organization in Hong Kong, said the debate over managing public health insurance will intensify as the population ages. After the state justified the change by saying the money should go to those who need it most, "people in places like Wuhan who have enough money in their personal accounts feel their benefits are being cut," he said.

Many in Wuhan and Dalian expressed concern that they could not afford to charge more online for drugs needed to develop more severe symptoms.

"I can say with absolute certainty that all retirees in Wuhan have complaints," said a resident of Wuhan's government hotline, according to a statement posted online. "Health insurance reform needs to be done, but if we do it this way, we're not going to be able to get treatment," Caller said.

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Confusion over whether the changes would disproportionately affect some groups sparked outrage online after reports that civil servants would be spared the pay cut. A blog linked to the state-run newspaper Henan Daily called Wuhan a "radical" restructuring, making demand after demand and slashing workers' wages.

The state-run China National Health Insurance Journal rejected allegations that protesters had been brainwashed by rumours, saying, "If you understand the articles, the elderly will definitely benefit the most."

The city where the coronavirus was first discovered, Wuhan's lockdown has been China's longest and most chaotic. At first appearance, the authorities promised to cover all Covid-related medical expenses, most of which were local. With the lockdown set to last until the end of 2022, that number will rise, long before the rest of the world learns to live with the virus.

According to an Internal Revenue Service budget report presented to local lawmakers in January 2023, the city spent $1.3 billion on coronavirus and other related public health costs in fiscal year 2022. In 2022, Dalian spent $408 million to combat the coronavirus.

Lyric Lee in Seoul, Theodora Yu in Hong Kong and Vic Chiang in Taipei contributed to this report.

Thousands of retirees protested health care cost cuts in Wuhan and Dalian Radio Free Asia (RFA).