Elderly in China protested changes to health insurance in rare shows of dissent

HONG KONG — Large groups of older people protested in two Chinese cities this week over changes to their health insurance, in a rare public show of dissent.

On Wednesday, a crowd of mostly older people confronted police officers near a hospital in the central city of Wuhan, according to videos posted on social media and geolocated by NBC News.

Under the health insurance changes, which in Wuhan were announced late last year and took effect Feb. 1, more employer contributions will go into a collective pool of funds than individual savings accounts.

In a statement this month explaining the changes, the government of Wuhan said they would benefit everyone in the long run, especially when it comes to general outpatient treatment. Protesters say the changes will increase expenses for healthy older people who don’t spend enough on doctor visits to meet the reimbursement threshold.

Care for the elderly has become a growing challenge in China, where the population has declined last year for the first time in decades. As the population ages, there are fewer workers to pay for the pensions and other benefits that retirees expect the state to provide.

In one video, protesters — many of whom worked for the government or state-owned enterprises — sang “The Internationale,” an anthem used by communist groups including the Communist Party of China.

Videos showed a similar protest Wednesday in the northeastern port city of Dalian, in what one hashtag describes as the “white hair movement.”

There was no sign of larger unrest of the kind that swept China late last year, when people across the nation protested strict “zero-Covid” measures that were then abruptly lifted.

While those measures minimized the country’s Covid cases and deaths for much of the pandemic, they also came at a great cost to the Chinese economy.

Annual budget reports from local governments show that Chinese provinces spent at least $51.6 billion trying to stop Covid outbreaks in 2022 alone, Reuters reported. Of that, more than $10 billion was spent in Guangdong, China’s biggest provincial economy, where spending was even higher than in 2020 and 2021 as officials struggled to suppress the highly transmissible omicron variant of the virus.

The anti-Covid spending, combined with a crisis in the crucial real estate industry, is believed to have left provincial governments in financial distress and looking for ways to cut costs.

Winnie Yip, professor of global health policy and economics at the Harvard TH Chan School of Public Health, said the health insurance changes would create “a more equitable system” in that it would make more funds available for people who earn less or have more serious health issues.

“I think that the protest comes from an individual’s perspective,” she told NBC News. “They all of a sudden said, ‘Oh, now there’s less money going into my savings account.’”

Yip said officials needed to provide more explanation to the public, not just about the changes but also about how insurance works.

“You pool all the risks together so we can help each other,” she said. “Part of the understanding is also for healthy people to know that one day they will be ill, and then they will be protected. That’s the whole concept of insurance.”

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