Go back to the prosperous days and become a layman

Chapter 806 805 Cooperative Medical Care
"Uncle Yin, could you at least wait until I finish my meal?" Tang Zhitong was both amused and exasperated by Yin Fugui's request.

Having heard Xu Xian recount Yin Fugui's deeds before, Tang Zhitong felt no aversion towards him whatsoever. It was truly remarkable that someone could abandon the pursuit of progress amidst the torrent of change, maintain a clear mind, and withstand pressure from above to fight for the survival of the commune members.

Tang Zhitong could only admire this kind of person, so he didn't call him "Captain Yin" from the beginning, but instead used the more affectionate "Uncle Yin".

"Hehe, you eat, you eat." Yin Fugui felt a little embarrassed. The representative had come to the Nanyu Production Brigade, and not only had he not treated him, but the other party had also given him grain coupons. He had said these things before the other party had finished eating, which was indeed a bit too eager.

Tang Zhitong didn't keep Yin Fugui waiting any longer. After slurping down his food, he wiped his mouth and asked, "Uncle Yin, I heard from Xu Xian that our production team has already covered the costs of treating common illnesses for its members. To what extent do you plan to extend the medical insurance coverage next?"

"Comrade Tang, do you see any opportunity for our commune members to enjoy the same treatment as city workers? Workers go to the fields to produce goods for the country, while we commune members go to the fields to grow grain for the country. Although the yield is not high when the harvest is bad, the work of commune members is no easier than that of workers." Seeing Tang Zhitong ask, Yin Fugui immediately raised his expectations to the maximum.

"Uncle Yin, you really dare to dream! Although I agree with what you said, this is simply impossible. After all, there are different levels of contribution." Tang Zhitong was speechless after hearing this. Yin Fugui really dared to dream!
Currently, workers enjoy the best medical benefits. Not only are their own medical expenses almost fully reimbursed, but their immediate family members are also partially reimbursed by their employers for hospitalization.

Even organizations like the post office can't compare when it comes to reimbursing expenses for immediate family members.

Currently, only two groups—government civil servants and university faculty and students—enjoy publicly funded medical care, but this benefit is limited to individuals and does not extend to their families.

Workers' medical expenses are reimbursed by their employers. Tang Zhitong didn't know how their employer and the government handled these expenses, nor had he asked. But in the eyes of ordinary people, this was no different from public medical care.

Of course, farmers also have the right to see a doctor, but since they don't have an employer to reimburse them, they have to pay out of pocket.

Even decades from now, when medical insurance is relatively comprehensive, there will still be different levels of coverage. Some people will be fully reimbursed; some will have a regular reimbursement rate of around 95%; some will have a comprehensive inpatient reimbursement rate of around 75%; while farmers will only have a comprehensive inpatient reimbursement rate of around 65%.

Of course, the contribution base for medical insurance is different for each group.

Some people might say, "I have money, I can pay more, and I also want to enjoy full reimbursement or 95% reimbursement."

That just means you're overthinking it. Your job position limits the types of medical insurance you can get. If you want to get more reimbursements, you either need to pass the civil service exam or buy commercial medical insurance out of pocket.

“I’m not saying that the contributions of the commune members are small, but how many commune members are there in the whole country? If this were to be implemented nationwide, the country simply couldn’t afford it!” Tang Zhitong said, trying to make amends when he saw that Yin Fugui was somewhat dissatisfied with his statement that “contributions vary in size.”

"Goodness, you've really thought long-term. I was only planning on this small plot of land in the Nanyu Production Brigade." Now it was Yin Fugui's turn to be surprised. He had heard that a representative had come to Nanyu to learn about the medical situation, so he was thinking about how to benefit the commune members. He hadn't thought about anything on a larger scale.

"You're a responsible team leader, and your idea is good, but the higher-ups won't agree. Even if I insist, there's no chance it will pass. It might even ruin the expansion of medical insurance for the members." He should be praised, but some bottom lines can't be crossed lightly.

Tang Zhitong's purpose this time was to improve the welfare of the commune members around Beijing. He couldn't ask for an exorbitant amount; he had to proceed gradually. Once it was implemented in Beijing, it would have a chance to be implemented in other places, and then it could be promoted nationwide.

Tang Zhitong, being from a farming family, knows all too well the hardships of farmers. Sun Shao-ping's grandmother in "Ordinary World" is a typical example. She was blind and could only take painkillers, and painkillers couldn't be taken every day because they were expensive.

“But our team isn’t wealthy either; we have many expenses on a daily basis.” Yin Fugui was somewhat disappointed upon hearing Tang Zhitong’s words.

"I heard from Xu Xian that there is still a shortage of medicine, but in my opinion, Nanyu has done a good job."

How about this? You calculate how much spare money you can come up with at the end of the year. I'll go back and report this to the higher-ups, and ask the city to cover part of the cost. Of course, individual members will also have to cover part, but they will definitely cover the smallest portion.

If this can be done, commune members won't have to pay for medical treatment in the city anymore; they can go directly through the unified fund, with settlements made directly between the two organizations.

Tang Zhitong's approach to improving medical security for commune members was basically the same as it was decades later, following the path of cooperative medical care.

"Then let me do the math." Tang Zhitong's proposal did not meet Yin Fugui's expectations. He was somewhat disheartened and reluctantly took out the production team's account book and began to look through it.

Tang Zhitong watched helplessly. It wasn't that he didn't want the production team to use public medical care, but the rural population was too large, and even if he brought it up himself, the city wouldn't agree.

The Nanyu production team now has more than 10,000 yuan in its accounts, which greatly exceeded Tang Zhitong's expectations.

"Uncle Yin, I've visited several production teams these past few days, and Nanyu is the richest one." After seeing the amount, Tang Zhitong gave Yin Fugui a thumbs up, which was definitely a testament to his effective leadership.

"Sigh, even though there's money in the account, we can't spend it all on medical care. The team needs to buy cattle, mules, hoes, mattocks, and so on. This amount of money is simply not enough." Although Yin Fugui really wanted to provide better medical care for the commune members, he still felt the pinch when it came to spending money. In his mind, it would be great if Tang Zhitong could persuade the higher-ups to cover all the costs.

"Look at what you're saying. It's only the beginning of spring, and the summer harvest is just around the corner. After the summer harvest, the government will pay for the grain, right? And there will be another sum of money after the autumn harvest, right? I've come all the way from Beijing, and the wheat from the Nanyu production team is the best. This year, we're sure to have a good harvest." Tang Zhitong showered Yin Fugui with praise as if it were free, afraid that Yin Fugui would change his mind.

The other production teams are still struggling to find food and can't afford to worry about cooperative medical care right now. Tang Zhitong is not willing to let go of the opportunity he has finally found in Nanyu.

“Last year’s harvest was alright, and we paid more grain to the state, but we didn’t have much money left. You’ve seen the accounts, and our team can’t use all of it for some kind of unified allocation. At most, we can contribute a thousand yuan a year.” The production team had many expenses, and after thinking about the situation over the past two years, Yin Fugui gritted his teeth and gave Tang Zhitong a number.

“Okay, I’ll go back and try to get the health department to cover a portion of the cost.” A thousand yuan, when averaged out, is less than one yuan per member, but Tang Zhitong didn’t think it was too little.

In Tang Zhitong's view, the production team was equivalent to the commune members' work unit, and since land, as the most important means of production, belonged to the collective, the production team had to pay for this part of the money.

Although the "Model Charter of Advanced Agricultural Production Cooperatives" in 1956 clearly stipulated the collective's responsibility for medical care for its members, firstly, there was a shortage of doctors in rural areas, and secondly, with the rapid advancement of collectivization, the cooperatives collapsed, making medical care for farmers impossible.

Production brigades around Beijing didn't implement cooperative medical care until 1969, after the winds had blown. The production team paid one yuan per member as a pooled fund, and each member paid another yuan (mostly deducted and paid by the production team). The health department didn't contribute any money...

If we can successfully get the health department to cover a portion of the costs, with the rest borne by the individual members, then we will truly have performed a great deed.

Moreover, for the health department, contributing a few dollars to each member is not a large sum, considering that there are only 276.7 million rural residents in Beijing, while the annual expenditure on public medical care exceeds ten million dollars. Besides, this two million dollars will not be all allocated this year; it must be allocated starting with pilot programs, and only after successful implementation will it be released. This allows time for all parties to adapt and coordinate.

"Comrade Tang, please put in some effort and ask the health department to contribute more. Ideally, the commune members shouldn't have to pay anything. We commune members are really struggling. We barely make ends meet all year round." Although Tang Zhitong had provided a plan, Yin Fugui kept testing Tang Zhitong's limits. From his perspective, he had to try to reduce the commune members' share of the burden as much as possible. After a year of hard work, the commune members could only earn about a hundred yuan each.

“Uncle Yin, the commune members still need to contribute some money. If individuals don’t contribute, and it truly becomes a case of free medical care, I estimate that there will definitely be people with aches and pains here and there. Spending money and time on screening patients is a waste.” Tang Zhitong believed that the vast majority of commune members were good, but human nature cannot be amplified. When some people do evil and are not punished, more people will join in.

The fact that potatoes were snapped up and snacks were all taken away is the best example.

Since members don't have much money, they have to pay a portion of the cost, which can effectively reduce the waste of medical resources. Besides, with barefoot doctors around, minor illnesses can be easily nipped in the bud, so that this money can be used for members with serious illnesses or those who are truly in need.

All of this was based on the establishment of the commune. Without the commune, Tang Zhitong would not have intended to get involved in cooperative medical care.

Without communes, no matter how much the cooperative medical system is touted as a miracle, the vast majority of farmers, limited by their millennia-old small-farmer mentality, would not have joined.

Besides concentrating resources to accomplish major tasks, there was another important reason for establishing communes: land sales and mergers had already occurred in some areas before the implementation of communes.

Keep in mind that it has been less than ten years since the land was distributed. If this trend continues, another group of landlords and tenants will soon emerge.

The establishment of communes provided farmers with a means of survival and was also a form of indirect protection for the vast majority of farmers.

That night, Tang Zhitong once again found a secluded corner to settle into her small house.

After dinner, by the dim light of the candle, Tang Zhitong took out a pen and paper to organize the proposals, the most important example being the Nanyu Production Brigade.

While it's important to reflect the overall will of the Nanyu Production Brigade when writing a proposal, that's not the most crucial point. The most crucial point is to clearly state the motivation and benefits.

Tang Zhitong hopes that cooperative medical care will be widely promoted around Beijing. Without sufficient benefits, the health department may not be willing to spend the money.

The primary reason for prioritizing this is undoubtedly to safeguard the health of the general public.

Taking advantage of the lingering influence of the barefoot doctor movement and leveraging the remaining authority of the directives to launch cooperative medical care, they stood firm on the greater good.

The next step is simply to improve the cohesion of the production team, increase the enthusiasm of commune members to participate in production, and contribute to increased grain production and a bumper harvest.

Tang Zhitong even added that cooperative medical care could, to some extent, promote the clearing out of urban household registration and temporary residents by rural residents returning to their hometowns.

Temporary residents and ordinary residents without workers in their families in Beijing do not have medical insurance. People like Zhang Guifang, Fengzhen, Fengzhi, Jingying, and Jingmin do not have medical insurance.

The situation in rural areas is expected to improve next year, which may be a good option for some impoverished urban families to return to their hometowns. Although they will have to work, at least they will have food to eat and their medical problems can be solved.

However, the clearing-out work in Beijing was mostly carried out in stages. When it was being carried out, it was a whirlwind, and once it was over, it was left unattended.

The food supply in Beijing is becoming increasingly tight. Based on what Tang Zhitong has seen in the past two or three days, it seems unlikely that a bumper harvest will be achieved this year, and further clearing out of grain will definitely be necessary.

Let's find this reason first, so that the Returning Home Office can use it directly later.

As for the possibility that the health department might not pay this amount, Tang Zhitong felt that was certain, but he did not intend to let that happen.

What's wrong with giving each farmer one yuan? Is that a lot of money? We've been talking about workers and peasants for so many years, and what have farmers given in return for their labor, food, and labor? Shouldn't we at least give them some hope?
If managed well, cooperative medical care could last for about 20 years. However, with the implementation of the household responsibility system and the large-scale contracting of hospitals, cooperative medical care collapsed. It wasn't until after the millennium, with the introduction of the New Rural Cooperative Medical System, that farmers finally had medical security.

Tang Zhitong doesn't believe in the idea of ​​"bitter before sweet." He believes that if things are bitter first, the later ones may not be sweet, but if things are sweet first, then they definitely will be sweet.

Saturday, May 7th, sunny, the temperature remains cool.

Xiao Wang has been in a good mood these past few days. The lyrics for "The Athletes' March" have been finalized, and he is now preparing to record it. Once the recording is complete, it will be broadcast on the radio.

Will her husband be pleasantly surprised to hear this? Xiao Wang is really looking forward to it.

However, this morning, Xiao Wang was a little depressed because her period had started.

After failing to conceive for several months in a row, Xiao Wang even began to suspect that there was something wrong with the two of them, and his worry was evident on his face.

"Sister-in-law, are you feeling unwell today?" Before breakfast, Fengzhi noticed that her sister-in-law was acting strangely, with no smile on her face, so she asked timidly.

"It's okay, wash your hands and eat." Xiao Wang composed himself, forced a smile, and patted his sister-in-law's head.

"Anzi, come back soon!" Zhang Guifang could tell that her daughter-in-law was unhappy. As she counted the days, she had her own guesses.

"Yes, he has a meeting on the 10th. He might be back tomorrow, or at the latest the day after." Thinking of her husband, Ms. Wang longed for his return; at that moment, she needed a loving hug…

(End of this chapter)