Session 3/7c Social Protection Policies in the Context of Population Ageing in China DU MIN CPDRC

Main Contains Status Quo and Trend of Population Ageing in China The Development of China's Social Protection Policies for the aged population and Existing Problems China's Reform on the Social Protection Policies for the Elderly

I. Status Quo and Trend of Population Ageing in China 1. The elderly population is huge and the aging speed is fast Chinese population aged 65 or above hit 144 million in 2015 The proportion of elderly population has increased from 6.4% in 1996 to 10.5% in 2015. The elderly population will go up by 261 million in 2030, accounting for 18.1% of gross population, and up further by 394 million in 2050, accounting for 28.1% of gross population.

Population Pyramid of China in 2010, 2030 and 2050

I. Status Quo and Trend of Population Ageing in China 2. The high incidence rate of chronic diseases and disability rate among the elderly there are approximately 150 million elderly people suffering from various chronic diseases and 40 million suffering from disability or partial disability.

I. Status Quo and Trend of Population Ageing in China 3. Aging is accompanied by the urbanization in which the traditional family disappeared rapidly The function of traditional families needs social protection policies to make up for them

II. The Development of China's Social Protection Policies for the aged 1. Establishment and development of social endowment insurance system social endowment insurance system established in 90s of last century. The two major systems of Urban Employee Basic Endowment Insurance, Urban and Rural Resident Basic Endowment Insurance constitute the basic old-age insurance system in China. The two systems now cover 850 million people, and coverage has reached 85%.

II. The Development of China's Social Protection Policies for the aged 2. Establishment and development of social medical security system

China New Rural Cooperative Medical Scheme Quantity of Participants （100 million） Medical Insurance Participation Rate (%) Per Capita Funding (Yuan) Funds Expenditure (100 Million Yuan) 2004 0.8 75.2 50.4 26.37 2005 1.79 75.7 42.1 61.75 2006 4.1 80.7 52.1 155.81 2007 7.26 86.2 58.9 346.63 2008 8.15 91.5 96.3 662.3 2009 8.33 94.2 113.4 922.9 2010 8.36 96 156.6 1187.8 2011 8.32 97.5 246.2 1710.2 2012 8.05 98.3 308.5 2408 2013 8.02 99 370.6 2909.2 2014 7.36 98.9 410.9 2890.4 2015 6.7 98.8 490.3 2993.5

II. The Development of China's Social Protection Policies for the aged 3. Establishment and development of social assistance system China's social assistance policies came out late, as marked by the launch of poverty reduction plan in 1980s, the official establishment of urban resident subsistence allowance system in 1999 and rural resident subsistence allowance system in 2007. The urban and rural subsistence allowance systems have become the pillar and score of China's social assistance system.

III. The Problems of China's Social Protection Policies for the aged 1. Social transition brings impacts on the traditional role of family in elderly support, leading to the shortage of family-based elderly support resources -- Modernization has brought changes to the family values -- The high labor force participation rate among women -- Outflow of massive young adults from rural areas -- The establishment of social security system and public service system

III. The Problems of China's Social Protection Policies for the aged 2.Fragmented basic social insurance scheme and the poor social security system in rural areas can hardly meet the subsistence needs of the elderly Different types of social insurance available for different registered permanent residences and different occupations; The unfairness can also observed from the different level of coverage between urban and rural areas and between regions.

III. The Problems of China's Social Protection Policies for the aged The pension received by the urban elderly reached RMB 26,000 in 2013, whilst this figure was only RMB 3800 among the rural elderly. From the perspective of coverage, the pension received by the urban elderly accounts for 82.5% of their personal incomes, whilst this figure is only 36% in rural areas.

III. The Problems of China's Social Protection Policies for the aged 3.Late start of social assistance system and imbalance among regions Although the subsistence allowance system is constantly raising the allowance, the coverage of this system is rather small in underdeveloped rural areas. The subsistence needs of certain underprivileged groups have not been satisfied. Elderly poverty has turned out a noteworthy issue.

III. The Problems of China's Social Protection Policies for the aged 4. Major urban-rural gap in terms of basic public services and low level of basic public services in rural areas The long-lasting urban-rural gap in public services has contributed to the fact that the basic public services including medical care in rural areas lag far behind urban areas. For example, the self-care ability, mental health and the chronic disease consultation rate among the rural elderly lag far behind the urban elderly.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly 1. Narrowing the gap between urban and rural areas and between regions in terms of social security and basic public services. The social security system has shifted from the preliminary stage of quick establishment to the stage of fair social security.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly By 2016, all the provinces have rolled out relevant household registration reform plans, most of which propose to cancel the agricultural household. Such reforms have paved the way for eliminating the urban-rural gaps associated with benefits, support and public services. the unified Urban-Rural Resident Basic Medical Insurance System and Basic Endowment Insurance System are being established.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly 2. Leveraging the poverty alleviation strategy to accelerate institutional reform and strengthen the coverage of social protection system for the vulnerable groups. As of 2015, the number of population living in poverty totaled 55.75 million in China, with those suffering from illness-related poverty accounting for 42%. The elderly being the main victims of illness-related poverty.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly At the Fifth Plenary Session of the 18th CPC Central Committee, it's been determined to implement the poverty alleviation program in the period from 2015 to 2020 in order to help below-standard impoverished people in rural areas to get rid of poverty by 2020. To this end, the poverty alleviation work has been included into the national overall development strategy

Ⅳ. China's Reform on the Social Protection Policies for the Elderly China kicked off the health-related poverty alleviation program in rural area. ---Organize 800 thousand primary personnel to conduct health surveys and establish basic database of health-related poverty alleviation. --- the number of patients in poverty area is 7 million 340 thousand, and 52% of them get get medical treatment.

Health-related Poverty Alleviation Investigation in 2016 The investigation is conducted in 2129 counties of 25 province. Nearly 20 million people of 7 million 750 thousand households receive illness-related poverty survey.

Health Surveys for the underprivileged people

Ⅳ. China's Reform on the Social Protection Policies for the Elderly Initiate the medical security system reform by setting up the basic medical insurance, major disease insurance, medical assistance and disease emergency rescue linkage mechanism.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly ---The basic medical insurance has covered 97% of rural peasants, ---reimbursement ratio reaching 50% and 75% respectively for outpatient expenses and hospitalization expenses within policy coverage. --- the Major Disease Insurance Scheme for Rural and Urban Residents has covered more than 1 billion participating residents, with reimbursement ratio no less than 50% ---Ease the medical care burden of underprivileged people

Ⅳ. China's Reform on the Social Protection Policies for the Elderly 3. Attaching importance to family functions, stressing the supplementary effect between family and social support system, putting emphasis upon the role of family in elderly support and elderly care, and gradually rolling out the family support polices.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly The need for elderly support has become one of the fast-growing current and future social wants of China. In 2010, the Chinese Government proposed to strengthen the building of family development capability and improve the family development policies.

Ⅳ. China's Reform on the Social Protection Policies for the Elderly ---- The direction of family policy reform : To strengthen the support for family functions instead of replacing such functions To arouse the development potentials of family by integrating social assistance with capacity building To give social acknowledgement for acts of shouldering family responsibilities, Provide work-family balancing support for those taking care of the family

Ⅳ. China's Reform on the Social Protection Policies for the Elderly In practice, major measures include: Strengthening the community-based elderly day-care service and home-based elderly support service Promoting the integration of healthcare and elderly care, Exploring the establishment of long-term nursing insurance system Strengthening the support for families with the disabled, underprivileged families and elderly people living alone.

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