BEIJING, Sept. 8 (Xinhua) -- A week in hospital for kidney stone surgery left a food-delivery rider facing medical bills of nearly 10,000 yuan (roughly 1,400 U.S. dollars). After medical insurance reimbursement, he paid just over 2,000 yuan out of pocket.
The experience of Zhang Yuanxiang, a rider in Chengdu in southwest China's Sichuan Province, highlights the financial protection that China's basic medical insurance offers. It also demonstrates how the country is adjusting its social security system to keep up with a changing labor market.
Over the next three years, China will seek to enroll more flexible workers, migrant workers and people in new forms of employment in the basic medical insurance system, according to a notice issued on Tuesday by government departments led by the National Healthcare Security Administration (NHSA).
During the period, new enrollment and contribution models tailored to people in new forms of employment will be explored, while services for flexible workers will be improved to make enrollment easier, the notice stated.
An estimated 200 million people in China are engaged in flexible employment. This group includes not only food-delivery riders but also ride-hailing drivers, domestic workers and livestreamers. Together, they play a key role in keeping cities running, supporting the economy, and boosting consumption.
MEDICAL INSURANCE FOR EMPLOYEES AS FOCUS
A key focus of the campaign is to enroll more people in flexible employment in the basic medical insurance system for urban employees.
With basic medical insurance coverage stable at around 95 percent of the country's 1.4 billion population, many flexible workers may already be covered by the basic medical insurance for rural and non-working urban residents, but not by employee medical insurance.
Zhao Ying, an associate research fellow at the Chinese Academy of Labour and Social Security, said employee medical insurance offers stronger financial protection.
Enrolling in the scheme can further reduce out-of-pocket costs for routine medical care and medicines, with the benefits likely to be particularly noticeable for people with chronic conditions or those who frequently need medical care, Zhao said.
Food-delivery riders are a typical example.
Long working hours, irregular routines and the pressure to meet delivery deadlines can take a toll on their health, with many suffering from ailments such as lower-back injuries, gastrointestinal problems and tendon inflammation, said Ge Huimin, a healthcare security official in east China's Anhui Province.
In 2025, 69.82 million people in flexible and other forms of employment were enrolled in employee medical insurance, according to Huang Huabo, deputy head of the NHSA.
MAKING MEDICAL INSURANCE MORE FLEXIBLE
An obstacle to continuous medical insurance coverage for this workforce is frequent changes in jobs and places of work.
The three-year campaign emphasizes policy integration across government departments, streamlined services and technology to make medical insurance easier to join, transfer, pay for and use.
China will encourage megacities to remove household-registration restrictions on medical insurance enrollment based on a person's place of employment or residence, Huang said.
Efforts will be made to explore more flexible contribution arrangements, including allowing previous contributions to resident medical insurance to count toward employee medical insurance and offering options for quarterly, semiannual or annual prepayment.
Authorities will also improve access to online and offline services and introduce an integrated service allowing flexible workers to complete multiple enrollment-related procedures through a single process, said the official. ■
