Missing the barefoot doctors
五月 8th, 2008 — coolxin上学期留下来的一篇。我英文中文都不太好，所以译得不好，但还是尝试了，大家不要拍我。
欢迎指正。
加粗的地方实在译不出来。大家帮忙。呵~
Missing the barefoot doctors
原文来自经济学人
Missing the barefoot doctors
Oct 11th 2007 | LUOCHUAN
From The Economist print edition
怀念赤脚医生2007年10月11日|洛川
来自经济学人印刷版
Many a problem lies in the way of a “new socialist countryside”
步履蹒跚的社会主义新农村建设
Get article backgroundTHE county of Luochuan, on the loess plateau of northern Shaanxi Province, used to be one of China’spoorest places. Today it looks relatively prosperous. The main street of the county seat is lined with hotels and restaurants, and the reddening orchards of this apple-growing district stretch beyond the town. Household net incomes per head in rural Luochuan are now approaching the average for theChinese countryside. Last year they rose by more than 9%, slightly under average.
陕西省北部黄土高原上的洛川县，一贯是中国最穷的地区之一。现今，洛川看上去相对富裕了一些。县城主要街道的两旁，旅馆和饭店随处可见，离县城不远的苹果种植园里，硕果累累。洛川农村地区家庭人均纯收入现在正接近全国农村平均水平。去年，增长率超过9%，略低于全国平均水平。
During the Maoist purges of the 1960s, this was a place where, according to Luochuan’s official history,“everyone was afraid”. But memories of the Cultural Revolution have long since faded. Luochuan’s stateowned agricultural-machinery factory, which once turned out tanks and hand-grenades for Maoist mobs,has been idle for years and is trying to find a buyer. Farmers can now grow what they want, instead of grain as Mao insisted.
在毛泽东主义肆意横行的六十年代，这里，根据洛川官方历史，是一个“人人恐慌”的地方。但是，文化大革命的记忆早已褪去，洛川政府所有的曾为毛泽东的军队生产箱柜（Tanks,似乎不宜译成坦克）和手榴弹的农业机械工厂，已闲置数年，正苦寻买主。不像毛坚持要求农民们种粮食，（现在）他们可以随心所欲的种植。
But Luochuan’s rural citizens are nostalgic for the past. They want a public-health system that works.Mao’s system of “barefoot doctors” for country districts, set up in Luochuan in 1970, may have been rudimentary, but at least it was readily accessible and practically free. Public-health care in Luochuan, as elsewhere in rural China, is now in tatters. And the extent of rural discontent is at last becoming known,as western journalists are slowly allowed to explore the backward interior.
但是洛川的农民们有些怀念过去。他们渴求一套行之有效的公共医疗体系。1970年，洛川实行的毛泽东首创的农村“赤脚医生”系统，（那）或许是很粗糙的，但至少它很快就发挥了效应，并且是免费的。洛川的公共医疗体系，如同中国任何农村地区一样，现在还没有成熟。当西方记者逐渐获许去探究农民内心真实感受的时候，农民们的不满，终于渐渐浮出水面。
The Image Bank
In recent years China’s Communist Party has begun to pay attention to a deep malaise in the countryside: the prohibitive cost of health care and education for the rural poor, mounting debts at the lowest levels of government, bloated bureaucracy and a growing wealth gap between rural and urban areas. Riots have become common, fuelled by the attempts of avaricious governments to raise money by selling farmers’ land. Incomes may have been rising, but so has dissatisfaction.
近几年，中国共产党开始关注农村存在的严峻问题：用于穷人们医疗保健和免费教育的成本限制，基层政府的累累负债，逐渐膨胀的官僚作风，和日益扩大的城乡贫富差距。加之贪得无厌的地方政府试图以抛售农民土地的方式来聚敛财富，群众闹事已经屡见不鲜。 政府的收入也许是在增加，但(人民）对政府的不满也在升级。
In some parts of China,more than 60% of those in dire poverty have been driven there by medical expenses. And for many rural residents the higher levels of schooling are becoming unaffordable.
在中国的部分地区，超过60%处境悲惨的穷人已为医药费愁容满面。很多农民开始负担不起升学所需的更多的学费。President Hu Jintao and his prime minister, Wen Jiabao, like to take credit for what they portray as a change of tack. Under their leadership, the party’s emphasis has switched from an all-out pursuit of economic growth to the need for balanced development that takes more account of the country’s poorest.
胡锦涛主席和温家宝总理，喜欢称道他们称为变革的理想。在他们的领导下，该党开始转变一切追求经济增长的发展观，强调为了顾及这个国家的穷人们，需要平衡发展。
The need, they often say, is to build a “new socialist countryside”. At a five-yearly congress due to begin on October 15th (see article), the party, at Mr Hu’s request, will rewrite its own charter to give the president’s theory about the need for “scientific development” (meaning pro-poor and proenvironment) the same sanctity as the philosophies of Mao, Deng Xiaoping and Mr Hu’s predecessor,Jiang Zemin.
而这，就是他们经常说的，建设一个“社会主义新农村”。（2007年）10月15日召开的五年一次的代表大会，共产党，在胡锦涛的要求之下，将会把这位主席提出的科学发展观(意味着重视穷人和环境) 写入党章，使其理论地位上升到与毛泽东，邓小平和胡的前任江泽民的理论一样。
But among the rural poor there will be little celebration. “If peasants become better off, the country is secure,” said Mr Wen earlier this year. On average, they are becoming wealthier. For the past three years rural income per head has risen by more than 6% annually in real terms. In the first half of this year, pushed by fast-rising food prices, it was up 13%, the highest increase since 1995 according to official media.
但穷苦的农民们，却极少会有为此拍手称道的。今年早些时候，温家宝总理曾经说过,“如果农民生活好起来，这个国家就稳定了。” 从平均水平来看，他们是在变得富裕。在过去的三年中，在真实收入（real terms,不确定怎么译）上，农村年人均收入提高了六个百分点。根据官方媒体报导，今年上半年，受快速上涨的食品价格刺激，这项指标上升了13%，长幅达到了自1995年以来的最值。
But the gap between rural and urban incomes has continued to widen. And progress has been far slower in areas like Shaanxi, far from the prospering coast (see chart 1).Rural China is still home to about 60% of the country’s 1.3 billion people, but agriculture’s contribution to GDP has fallen from more than a quarter in 1990 to less than 12% today. Centralgovernmentspending on agriculture and rural welfare as a proportion of total spending has similarly fallen from 8-11% in the 1990s to 7-8% for most of this decade. Thanks to a booming economy under Mr Hu and Mr Wen, the central budget is gettingbigger and its expenditure is growing fast. But outlays on health care and education, as a proportion of total spending, remain lower than they were a decade ago.
但是，城乡收入鸿沟依然在扩大。政府制定的发展计划在如陕西那样的地区实施起来非常困难，远远落后于欣欣向荣的沿海地区。中国13亿人口中，大约有60%仍然住在农村，但是，农业对GDP的贡献却由1990年的超过15%下降到了如今的不足12%。这十年来，中央政府在农业和农村福利上的支出，占总支出的比例同样由上世纪九十年代的8%-11%下降到了7%-8%。胡温领导之下，经济快速发展，中央财政预算大大增加，政府的开支也在飞速增长。但是在医疗保健和教育上的花费，其所占国民总支出的比例，却比十年之前还低。
Where boom doesn’t reach
The 2,217 delegates to the congress, for whom dissent is taboo, will praise Mr Hu’s achievements. For the first time in Chinese history, farmers, except for tobacco-growers, have been exempted from tax on their land or agricultural production. This has marked the end of a process of rural tax cuts that beganwell before Mr Hu took office. Since 2003 a new medical-insurance system, involving for the first time a financial commitment by the central government, has been set up in at least 80% of rural counties in place of the long-discarded barefoot-doctor scheme. At the same time, rural children have begun to
enjoy free education during their nine years of compulsory schooling—although many still have to pay for their textbooks.
繁荣的漏洞参加代表大会（十七大）的2217名视异议为禁忌的代表，他们会大肆赞赏胡先生（执政期间取得）的成就。中国历史上第一次，农民，烟农除外，可以不再缴纳农业税。这标志着胡先生执政之前就开始的农村税费改革的结束。2003年，一套首次由国家财政支持的新医疗保险方案，开始在超过80%的中国农村地区试行，以此来代替早已不复存在的“赤脚医生”。 于此同时，农村孩子开始享受免费的九年义务教育—尽管，许多人还是要支付书本费。Since 2004 the government, for the first time, has been giving direct subsidies to grain farmers in an effort to keep them growing grain and to curb grain-price rises. This year the subsidies are due to rise 63%, to 42.7 billion yuan ($5.7 billion). Grain output has risen for three consecutive years, the best stintof growth since 1985. But high grain prices may have encouraged this more than the subsidies, which have been largely offset by the rising cost of fuel, fertiliser and other materials.
2004年，政府首次直接向种粮农民提供补助，目的是为了鼓励他们继续种植粮食以抑制粮价飞涨。今年，补助提高了63%，达到了427亿人民币（57亿美元）。粮食出口连续三年保持增长，1985年来的最佳。但是更高的粮食价格比起补助来更能刺激粮食种植，补助大部分被燃料，肥料和其他物资价格上涨所消耗的成本抵消。
The changes are a temporary salve, at best. In the case of the medical-insurance scheme, the biggest beneficiaries are the richest peasants. The poorest are just as likely to choose to die at home rather than risk deeper impoverishment of their families by venturing into hospital. The measures also do next to nothing for a huge section of the rural population that has moved to the cities in recent years. These people, perhaps 150m of them, enjoy neither the recent benefits accorded to those who have stayed on the land nor the far greater subsidies enjoyed by their city-born counterparts. In 2004 the World Health Organisation (WHO) described the launch of the new medical system during such a rapid population shift as “the equivalent of launching a ship with a radically new design at the height of a typhoon”. The ship is not weathering well.
这些改革只能暂时缓解（压力）。在医疗保险方案上，收益最大的是那些富裕的农民。贫穷的农民，则很可能只能选择呆在家里等死也不能冒去医院看病，因为这会使家庭陷入更深层次的贫困之中。同样，这项措施，对于那些近年来已经流入城市的农民来说没有任何的益处。这些人，其中或许有一千五百万人，既无法享受到这项措施给予住在农村住户的优惠，也无福享受到那些身处同一城市的城市居民可以获得的更多的补助。2004年，在如此快速的人口流动的情况下，世界卫生组织（WHO）出台了一项新的医疗体系，而这就像是“让一艘全新型号的轮船面对最强级的台风” ，这艘船显然没有很好的掌握天气情况。
In Jiuxian, one of Luochuan’s 16 townships, the hospital is one of the better looking buildings amid a hotch-potch of grey and brown Mao-era edifices (some of them “caves”, built directly in the loess soil and open only at the front). It has recently been rebuilt at a cost of 4.5m yuan. A cluster of crates in the lobby containing new medical equipment has yet to be unpacked. A handwritten notice explains how the township’s 14,000 citizens, most of them scattered in 34 surrounding villages, can enjoy the benefits of what is known as the “new co-operative medical system” introduced three years ago.
在旧县，洛川县16个镇之中的一个，镇医院是这里最好看的建筑之一，它周围是破败的毛时代留下来的建筑（其中一些是窑洞，直接挖在黄土地里，只在前部安个门窗）。镇医院最近花了4.5万人民币翻新。大厅里摆了一推未开启的装着新医疗仪器的箱子。一份手书的通告告之全镇十四万人民，他们基本上散居在周围的34个村子里，可以享受三年前就已经提出来的所谓的“新合作医疗体系”了。
The system sounds a good deal. For a premium of a mere 15 yuan (about $2) a year, Jiuxian’s residents can claim back a big part of their hospital costs. Before 2004 they had no insurance at all. Now, beyond a certain threshold (which varies between 100 yuan and 600 yuan according to the quality of hospital) andup to a ceiling of 10,000 yuan a year, they can reclaim between 40% and 60% (the better the hospital, the lower the percentage). The premium is waived entirely for the “impoverished”, of which there are several hundred in the township. For each premium paid, the central government contributes another 10yuan. The provincial, prefectural and county governments add a total of another 10 yuan to the kitty.
这个体系听上去很好。每年只要缴纳15元人民币（大约2美元）的保险，旧县镇的居民就可以报销他们看病的大部分花费。2004年之前，他们根本没有保险。现在，在一个规定的最少值（根据医院级别的不同，在100元到600元之间浮动），到1万元之间，他们可以报销大约40%到60%（医院越好，比例越低）的医药费。极其贫穷的人可以免交保险费，在这个镇子上，这样的人有好几百。每一份保险，中央政府负担另外的10元。省、市、县政府负担10元。
premiums may sound small for such potentially great rewards. But for rural residents, who earned on average 3,371 yuan last year, 15 yuan amounts to nearly two days’ income. In Luochuan, as in other counties where the insurance scheme has been launched, officials have reported very high rates ofparticipation by farmers, usually over 80%. But a former senior official in Luochuan’s health bureau says participation has not been as voluntary as officials make it out to be.
如此回报丰厚的保险，这样的费用听起来真的很少，但是对于去年平均收入仅仅3371元人民币的农民来说，15元是他们两天的收入。洛川，如同其他已开始实行医保的县，当地政府公布了很高的参与率，通常会超过80%。但是，洛川县卫生局的一位高层官员透露，自愿参与投保的人数比政府公布的要少得多。
Yang Xiumei, who is lying on a hard bed in a small, dim ward (left untouched by upgrading) of Jiuxian’s hospital, has picked the wrong time to suffer haemorrhaging and abdominal pains. In her village, says the 44-year-old Ms Yang, officials told farmers that insurance premiums would be deducted, whetherthey liked it or not, from subsidies they were due to be given for growing grain. But they have received neither the subsidies nor the crucial enrolment booklet for the insurance scheme. The hospital considers her uninsured, and her costs are mounting
.杨秀梅（音），她躺在旧县镇医院那狭小暗淡的病房里（保险使她茫然无措），不幸在这个时候得了溢血和腹痛。这位45岁的杨女士告诉说，她所在的村子，官员对农民们说无论他们乐不乐意，医保费一律从种植谷物的补贴中扣除。但是，农民们从未得到任何补贴也没有拿到证明性的医保登记册。（因为没有证明）医院认为她没有投保，要她自己负担所有的费用。
if Ms Yang had received her booklet? Her insurance would not kick in until she had spent 100 yuan, the equivalent of nearly 11 days’ income for the average Luochuan rural resident. Beyond that she would then be able to claim 60% of her expenses, but these could amount to several hundred more yuan even for a relatively minor complaint. The Jiuxian hospital, with its three doctors, can perform only the simplest operations and provide only basic care. Anything more serious requires a trip to the Luochuan county seat, 20km (12 miles) away. For insured Jiuxian residents who used county-level facilities, average out-of-pocket expenditure in June was 1,219 yuan, or four months’ income.
那么如果杨女士收到了她的登记册又会怎样呢？她只有花费100元以上，100元相当于洛川农民平均11天的收入之和。之后，她方能报销40%的费用，但就是相对轻微的病痛，（除掉报销后）合起来仍需要花上几百元。旧县镇医院，有三个医生，只能进行一些最为简单手术和提供最基本的救护。病情稍严重，只能送往20公里（12英里）之外的洛川县医院。对旧县镇那些已投保的在县医院就诊的病人，6月份的花费是1219元，或者说是四个月的收入。
Unnecessary X-rays
Hospitals are under pressure to push up charges. Jiuxian’s hospital is subsidised by the county government, but only enough to cover 85% of its staff’s wages, which are relatively generous. The rest of its money has to come from fees and selling medicine. The government caps the prices of common medicines, but doctors get round these by prescribing other medicines or ordering unnecessary procedures, such as X-rays. Without changes in the way rural hospitals are funded, poorer farmers will feel little benefit from the new insurance scheme. Henk Bekedam of the WHO says the poor would not even be able to find the cash to pay for treatment at first, even though some of it would be reimbursed.
多余的X光医院不得不抬高收费。旧县镇医院的支出由县政府拨款，但也只能拨给85%的职工工资，这已是相当慷慨了。剩下的钱只能来自诊费和药费。政府控制了基本药品的价格，但是医生通过开其他药品或者不必要的检查，比如拍X光，来获利。如果农村医院不改变这种状况的话，贫穷的农民将感受不到新医保的任何好处。WHO的Henk Bekedam说，穷人甚至没有足够的现金支付一诊费用，即使药费可以报销。
Researchers from the Chinese Academy of Social Sciences in Beijing have been trying to set up a parallel insurance system in Jiuxian. Under this scheme, farmers have been encouraged—more politely this time—to pay another annual premium of 10 yuan. For this they are offered free consultations and drugs about 25% cheaper than those sold in the hospital. At first the academics tried using hospital staff to administer the scheme, but it quickly became clear that the doctors were not interested in prescribing cheap drugs, only expensive ones. As disgruntled farmers pulled out of the scheme in droves, the researchers scaled back their staff and closed down all but one of their six clinics dotted around the township. Now they have just one doctor, a pharmacist and a nurse manning a clinic-cum-dispensary in the township seat. The participation rate has dropped from 40% to around 12%. Charity donations, which had helped them, have recently run out.
中国社科院的研究人员在旧县试行了一种相类似的医保方案。这一方案相对温和的鼓励农民支付10元的年费。（这样）他们可以得到咨询免费和在医院买药便宜25%的优惠。起初，他们想让医院来执行这一方案，但是，很快就发现医生们不再开便宜的药方，只开一些价格贵的。愤懑的农民纷纷不再投保。政府于是调整了职员分配，将分布在镇区的6个诊所合并为一个，现在，镇医院只配备有一位医生，一位药剂师和一位护士。投保率从40%下降到12%左右。帮助他们的慈善捐助，最近中断了。
The county and township governments are not keen supporters of the researchers’ efforts. Their main interest is to ensure that Jiuxian’s hospital covers its costs. Funding it more fully from their own budgets would not be easy, especially since almost all agricultural taxes have been abolished. The official media hailed this as the lifting of a centuries-old burden on peasants. But rural governments in areas with few non-agricultural industries, though partly compensated by the central government for their losses, went into budgetary shock.
县和乡镇政府根本无心支持研究人员的努力，他们热心的是怎样确保旧县的医院能支付开支。而想从政府的预算中拿出更多的资金是不太容易，特别是在农业税几乎全部取消的情况之下。官方媒体赞誉此措施（取消农业税）实在是减轻了几个世纪以来压在农民身上的负担。但是，非农产业奇缺的乡镇，虽然中央政府的拨款部分弥补了税收收入的流失，但政府仍然还是陷入了预算的困境。
Cave-dwelling teachers
Zealous officials in Yanan prefecture, of which Luochuan is part, were among the first to respond to Mr Wen’s tax-abolition initiative. Buoyed up by revenues from local oil and gas industries, they abolished
住在窑洞里的教师洛川所属的延安市，政府官员们很热心，他们是第一批响应温家宝取消农业税政策的。靠着地方油气工业税收收入，他们取消了农业税。
agricultural taxes in 2004, resulting in a 200-yuan-a-year net gain on average for farmers in Luochuan, according to the official media. But Luochuan’s county and township governments struggled merely to meet payroll commitments for their staff. Subsidies received by Luochuan to cover its loss of tax income were fixed at the level of its agricultural tax revenues in 2002. But miscellaneous fees imposed on farmers earlier in the decade were lost too, according to a report in Macroeconomics, a monthly journal published in Beijing.
根据官方媒体的说法，2004年的农业税一取消，洛川农民人均多了200元的净收入。但是洛川县和镇政府艰难的支付着职员的薪水。国家拨给洛川的补助，用以填补农业税取消造成的收入损失，只是相当于2002年洛川农业税收入的水平。但是，十年来强征的各种费也一并废除了，北京出版的一本月刊宏观经济学如此报道。
Revenue losses have coincided with another extra financial burden: Mr Wen’s policy of free education for rural children. Education expenditure from the county budget increased by 20.8% last year, compared with increases of only 6.9% and 5.6% in the previous two years. More money provided by the central, provincial and prefecturalgovernments has helped, but not enough. Once again, Yanan prefecture has chosen to do things the hard way. It has required all schools not only to abolish fees (as ordered by the central government), but also to subsidise all boarders and give free textbooks to everyone. Luochuan county has to pay 10% of the cost of these extras from its own coffers.
税收损失的同时，还有另外一项额外的财政负担，温家宝提出的农村孩子免学费的政策。去年县财政教育预算提高到20.5%，而上两年相应的增长幅仅是6.9%和5.6%。中央，省，地政府提供更多的钱，但还是不能满足需要。延安市只好再次选择采取强硬的办法。要求所有的学校不仅要取消学费（中央政府也是如此要求），而且要给寄宿生发补助，并且给每位学生免费发教科书。洛川县政府为此拿出他们收入的10%。
At Anmin Junior Middle School, next to the county seat, so much money is flowing in to subsidise the free education programme, which began in Luochuan in 2005, that the school is handing out ten yuan in cash to boarders’ families every term. Last year, with a special grant of around 2.4m yuan, the school knocked down the teachers’ “cave” dwellings and built smart new dormitories for them. The school’s headmaster, Gao Feilong, says the dropout rate is now zero. In the 1990s soaring fees were forcing some of Luochuan’s pupils to quit school.
县城的安民初中，很多资金投入了2005年开始在洛川实行的免费教育计划，学校每学期给寄宿学生发10元现金补助。去年，大约240万人民币的特别补助，学校用这些钱为教师们盖了新宿舍好让他们搬出窑洞。该校校长高飞龙说现在学生退学率是零。在上世纪九十年代，高昂的学费迫使洛川的一些孩子无法完成学业。
A survey conducted by Shenzhen University found 82% of farmers in Luochuan were happy with the recent school-fee reforms. But they were far less happy with the quality of teaching and school facilities. Fixing these problems would require a lot more money from a county that is already spending a quarter of its budget on education (mostly on teachers’ wages). To cut costs, Luochuan has closed down nearly half of its 320 primary and middle schools since 2003, resulting in lay-offs for more than 700 teachers and forcing many more children to board. At Anmin School about half of the pupils live in a cramped, spartan dormitory building in a muddy yard at the back of the barrack-like complex. There may be no dropouts now, but for poorer students the huge cost of continuing their education beyond this level is a disincentive to study hard.
深圳大学主导的一项调查发现82%的洛川农民非常欢迎近期的学校收费改革。但是学校的教学质量和设备却远不能让他们开怀。解决这些问题需要很多的钱，而县政府已经将它预算的四分之一花在了教育上（重要是支付教师的工资）。为了削减开支，从2003年开始，洛川撤并掉了320所中小学的大约一半，结果导致700余名教师闲置，也迫使更多（路远的）学生只能寄宿。在安民学校，大约一半的孩子住在狭小破败的宿舍里，那宿舍建在复杂的木质建筑后的一个泥泞的院子里。现在是没有退学生了，但是，对穷学生来说，继续升学所需的高昂学费令他们无法努力学习。Luochuan’s finances would work far better if it cut its bloated bureaucracy. It is trying. The county government has, in effect, taken over management of township budgets, stripping the townships of what little power they still retained. Some provinces are now bypassing both the prefectural- and townshiplevel governments in order to get funds more directly to rural areas. But experiments with rural democracy—hailed by the party in the 1990s as a great way to improve public supervision of how money is spent—have proved too challenging to the party’s political grip.
如果裁撤臃肿的官僚机构，洛川的财政会运行得更好。实际上县政府接手管理乡镇的财政预算，架空乡镇政府旧有的一点权力，这是一种尝试。一些省份现在都绕过市县和乡镇一级的政府，直接为农村地区集资。但是，农村实行民主改革—-在上世纪九十年代被共产党大力鼓吹为可促进公众监督政府公开财务状况的伟大创举—-实在是对政府集权太具有挑战性（因而被证明是失败的）。
Many Chinese experts say the burden of supporting basic health care and education should be shifted to higher-level governments. That done, prefecture and township governments could be massively trimmed or eliminated altogether. But neither widespread lay-offs in an already volatile countryside nor a huge increase in central-government spending are palatable options for China’s leaders. Nor are they rushing to address the needs of those millions of country-dwellers who have moved in recent years to work in urban areas. Even peasants who have been living for several years in cities are still classified as rural residents, and as such are often excluded from urban welfare schemes.
很多中国专家说，基本的医疗保健和教育的负担应该转移到更高级别的政府。这样的话，县和镇一级的政府可以大量削减甚至取消。但是，在相对不稳定的农村进行大范围的裁员，或者大量增加中央政府的支出，都不是中国领导人能够很容易办到的。他们也不会急迫地想去满足数百万涌入城市的农民工们的愿望。已在城市居住生活数年的农民，甚至仍然被定义为农村居民，这部分人也因此通常无法享受城市居民的福利计划。
A former Luochuan resident working in Beijing, 700km to the north-east, would have to go back to the county for medical treatment if he wished to get reimbursement. Only a few million migrant workers enjoy medical insurance provided by their urban employers. From January 1st it will be compulsory for employers to offer it. But since many migrants are employed informally, without contracts, this will not make much difference.
洛川的一位在离北京市中心700千米的东北部打工的农民，如果他想得到报销医药费的话，他还得回洛川县。只有很少的农民工享受到了雇主承担的医保。从1月1日起，雇主会被强制要求给民工投报。但是，许多民工是临时受雇的，他们和雇主之间没有工作合同，因此有这份强令也起不了什么作用。
Such problems need urgent attention. Officials say that by 2020 about 60% of the population will be living in cities or towns. This implies that more than 200m more people will move from the countryside by then. That figure may be too alarmist: there are signs that urban factories are running out of migrant labour, and reports that bad working and living conditions in some cities are deterring the rural poor. But over the coming years China’s rural problems will increasingly become urban ones. China and its cities will need to spend a lot more to deal with them.
这些问题亟待解决。官员们声称，到2020年，大约60%的人口将会居住在城镇。这意味着，届时超过2亿的农村人会涌向城市。这一数字或许太危言耸听：有迹象表明，城市里的工厂正缺少劳力，也有报道称一些城市恶劣的工作和生活条件让农村的穷人很泄气。但是，接下来几年，中国的农村问题会渐渐成为城市需要解决的问题。中国和他的城市将需花费更多的精力来解决他们。