Local authorities in the interior provinces and rural regions in particular have been unable to properly fund health care. In 1999, only 7 percent of rural residents and 3 percent of residents in the interior had health insurance, compared with 49 percent of urban residents.1 In 2006, according to the Ministry of Health, fewer than 10 percent of rural residents were insured, compared with 50 percent of urban residents. It was also reported that 87 percent of rural residents paid for all of their health care. Experimental initiatives, like the New Rural Health Cooperatives (NRHC), launched in 2003 in 300 counties, have largely failed. NRHC offered limited health insurance to peasants: 30 yuan per person per year – 10 yuan each contributed by the participant and central and local governments – proved insufficient to cover participants’ medical costs. Even in 2006, when the central and local authorities both increased their contributions to 20 yuan per year, the 50 yuan total per peasant covered only 25 to 35 percent of yearly health care costs in rural areas. Many peasants, too, suspect that the usual rampant corruption plays a part – that local authorities are skimming the funds.
Recent health reforms have brought new problems. In 2010, as part of the national plan to promote domestic consumption, the government put forward guidelines for health care reform, along with an investment of $124 billion, 40 percent of which would come from the central government and the rest from local ones. The thinking was that if health care were improved, people would not have to save so much for medical costs and would spend more on consumer goods. However, the government never announced how the money would be allocated. The reform itself consisted of two parts: increasing funding for medications and medical equipment, and improving medical insurance coverage. The government planned to raise funds for the rural cooperatives to $18 per person in 2011, although at the time of writing there had been no release of information on how and where that would be done. Moreover, this was not a universal reform: Only sixteen cities (six each in central, western, and eastern China) were chosen to pilot it, with 5,000 township hospitals targeted for upgrading. InMedica, a medical research company, predicted that in China’s largely privatized health care system, the biggest winners in this reform would be medical equipment suppliers like Mindray, Beijing Wandong and Yuyue Medical. Private hospitals, too, including private foreign hospitals, would be favoured by the scheme. The rationale was that opening the door to foreign investment in health care would ease the burden of public health care, since middle-class patients would be more inclined to use foreign hospitals.
Peng’s first security job in Shenyang paid 1,300 yuan (£118, $206) per month. He sent two thirds of this money home, and kept the rest for his living expenses. He was able to pay rent, and spent very little on food – a few yuan a day. The best meal he made himself was two eggs fried with tomatoes, and he cooked this only occasionally. He had no other expenses – no transport costs, because he walked to work. He was guarding a local three-star hotel. There were three other guards working with him, who also came from nearby villages. Many of the hotel’s guests came from the southern provinces; others came from abroad. He had wondered about them and why they came to a place like Shenyang, a city he found dull and depressing. His job was not easy; hardest to bear was his supervisor’s daily bullying – shouting and name-calling – and one day he talked back. Two weeks later, he was dismissed without notice. Since then, he’d been back at the labour market, looking for work, but had found only a temporary job as a labourer on a building site not far from the market. The pay rate was two-thirds that of the security job, and the work only lasted two days.
The month before I met him at Lu Gardens, he’d found another security job, at a local brewery. The ad, like many listed at the labour market, had given no information about fixed wages. Such ads say only ‘good starting wage’ or ‘guaranteed good wage for the experienced.’ Peng took the job because he had no other option. When the first paycheck came, 1,000 yuan (£90, $158) for the same work he had performed at the hotel for 1,300, he asked for a raise and was immediately fired. His bosses said they couldn’t pay more, because of the global economic crisis – and they knew that they could find a replacement immediately.
‘Bosses can do anything they like,’ Peng said. ‘Heaven is high above and the emperor is far away. They don’t care about breaking the rules, precisely because the rules are not enforced.
‘In Shenyang, no one is on your side in these kinds of situations,’ he continued. ‘Arbitration is unfair and slow and always in the interest of the businesses. If worse things happen and you get injured, you can’t afford the costs to take the company to People’s Court. A Shenyang builder fell on a building site and lost his leg. He didn’t sue the company because he couldn’t afford to. Who cared about him? He’s one of us – from the countryside.’
Now Peng came to Lu Garden every day. He got up at around 6 a.m. along with his roommates. They usually cooked porridge for breakfast and ate it with pickled vegetables. Peng never had much appetite that early in the morning, so he’d leave the flat and walk alone to Lu Garden, through the quiet alleyways and streets. He enjoyed it; it was the most tranquil part of his day. When he arrived, a crowd of job seekers was already there, well ahead of him, all eagerly waiting to see that day’s new opportunities. He would push himself to the front and scan the ads on the walls, taking notes, and then call up each number and ask for an interview. If he saw no suitable ads, he would walk around the market and chat with fellow job seekers. Sometimes he would sit on the floor in a corner and rest, before getting up again to look for more incoming ads. He would also walk around seeking potential employers – sometimes they would come down to look for individual workers to do a casual job, just for the day.
At noon, Peng would leave the market and buy his lunchtime buns from a vendor he’d known since his first day at Lu Garden. The bun seller had been a job seeker himself, but had given up looking for work and taken on this little street trade instead. The watermelon seller was in the same situation: unemployed labourer turned trader. Peng would take a fifteen-minute break, chewing his buns and chatting with them about news of the day. After lunch, he would get back inside Lu Garden and start searching again – new ads did come in throughout the day, so everyone carried on, hoping for a job. The latest Peng ever stayed was till 8 p.m., when his flatmates also packed up and went home.
As I was leaving Lu Garden myself that day, another man walked up to me and said, ‘Wait! I have something to show you. Would you like to see my poems and essays?’ His eyes sparkled with enthusiasm. ‘I wrote them in my years working away from my home village.’ He was Ren Jianguo, from Hugou village, Shanzuizi county, Liaoning province.
I followed him to his flat, like Peng’s just ten minutes’ walk from the labour market. We entered a tiny alleyway and turned a corner into a dingy-looking block of flats. He said these were mostly occupied by retired urban poor. I saw some men and women in their seventies doing calisthenics in the tiny public area in between the flats. They were in their pajamas, leaning on a metal pole and stretching their legs. I followed him up the stairs, which smelled bad. The railing had rusted. No doubt, this was among the most modest housing in Shenyang, as he told me – and migrants cannot afford anything better. All of his flatmates were still at Lu Gardens, waiting for work. By the look of the place, there must have been at least a dozen people living there besides him. But Ren Jianguo didn’t seem to care about the mess and the lack of space. He seemed interested only in what he’d written in black ink. He searched anxiously in a pile of documents on a desk next to an old washbasin. Finally, he found it: some fifty pages of handwritten poems and essays. ‘There! Please read it. It’s my sweat and tears,’ he said, pushing the papers into my hands.
The first page was titled ‘To My Parents.’ It told of his regrets over the years when he had not brought sufficient income from his job in Shenyang to support his aging mother and father, who had been farming the land in Hugou village:
One of the most pointless things in life is to exhaust yourself in rearing children. I say this for you, Mother and Father…I left home in tears, to make a living in the world outside. You had fed and clothed me for twenty years, and I had to leave to know what it’s like to be so giving. You had toiled in the fields, suffering and bearing the heat and the cold, just to pay for my schooling. You had cared for me and provided me with everything that there was. All you were hoping was that I would make a good life for myself one day. But how I broke your hearts – earning such a poor wage on a building site in a heartless