China plans to set up a healthcare insurance network by 2010 so that its 768 million rural residents can enjoy basic medical care.

Each province or autonomous region picked out two or three counties to trial the new system, which was first mooted in July 2003.

Although the Chinese Government is quite positive about the system, it will push ahead cautiously with the program.

President Hu Jintao and Premier Wen Jiabao have urged local health authorities to be fully aware that the pilot is an "arduous and complicated" reform.

Nie Chunlei, deputy director of the Rural Health Department under the Health Ministry, said China's rural areas covered a large territory and the people's demands for medical services varied a great deal.

"The central government has laid out the major principles and framework of the new system, under which various localities will experiment with the patterns that are most applicable to their conditions," he said.

The cautious attitude of the top leadership has resulted from the fact that China is still a developing country and there is still a big gap between urban and rural areas in higher incomes, education and many other fields.

Bed-ridden 83-year-old Hong Kainan spoke to China Daily from the township hospital in Wuyuan, giving his support to the cautious attitude.

Recovering from a stomach operation, Hong, a farmer from Hongcun Village, said he had not joined the system.

"I am old and might die at any time, so it would be a waste to join," Hong said.

Because he is not a member of the system, all his medical fees must be paid by his family.

He regrets the decision not to join now, learning that the financial burden on his sons and daughters would have been enormously reduced had he done so.

Daughter Hong Erli has also not joined the system.

"Since I was born, I have not been hospitalized, and without any serious diseases, why should I pay to be part of the system?" she said.

In her family, only her children are covered by insurance organized by the school.

"I don't have enough money left to join the system because our family is poor," she said.

Her husband brings in about 5,000 yuan (US$600) a year.

The family is also fairly ignorant about the system, and do not seem particularly interested to learn.

In Gaotian Village of Nanchang County, also a pilot county, 45-year-old Wan Jinxiang said neither her family nor many of her neighbors had bought insurance.

"We don't need it because we don't have serious diseases," she said.

In fact Wan could easily afford the premiums - in her case it's simply a lack of information about the system that has failed to change her mind.

(China Daily November 6, 2004)