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Worries about the cost of treatment discourage consumption despite improvements in healthcare insurance coverage

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Wang Jinchen apologises for not standing up to greet visitors to his freezing bedroom in Mashihaiwang village in China’s central Hubei province.

Tucked under a tattered quilt, the 70-year-old farmer — who is wasting away from uremia, a condition caused by kidney failure — embodies a problem that is prevalent across China, and that has far-reaching implications for efforts to boost growth in the world’s second-largest economy.

Wang’s family and millions like them are suffering from “catastrophic health expenditure” — medical costs that have devastated their household finances.

Dialysis treatment three times a week costs Wang more than Rmb1,700 ($233) a month on average, of which his medical insurance covers less than a third. Wang and his wife Yuan Dinglai’s only regular income is a monthly pension of Rmb200 each.

“We cannot farm any more, I have to take care of him when he’s unwell,” said Yuan, offering a cup of hot water in his bare room with its flaking paint and medicines piled on the basic wooden furniture.

As China has grown richer over the past two decades, it has expanded healthcare coverage. About 95 per cent of its 1.4bn people are now covered by some medical insurance, up from around 13 per cent in 2003.

Chinese healthcare coverage for reproductive, maternal, newborn and child health and infectious diseases is comparable to those in high-income countries, according to a 2023 paper published in the Lancet medical journal.

But the system still lags behind developed countries in its coverage of chronic diseases such as diabetes or hypertension, wrote Winnie Yip, professor at the Harvard School of Public Health, and fellow authors from Chinese universities.

“Moreover, China has disproportionately high incidences of catastrophic health expenditure compared with countries with similar economic development,” the authors of the paper wrote.

Such cases are disastrous for family finances but also damaging for the wider economy, according to experts who believe that the need to prepare for potential health emergencies is one reason why Chinese households are among the world’s biggest savers.

While China touts socialism as its guiding ethos, the government has prioritised pouring funds into strategically important industries, such as high-tech manufacturing, as well as infrastructure. Welfare spending has increased, but remains lower than many peers. President Xi Jinping in 2021 warned of the need “not to fall into the trap of ‘welfarism’ that encourages laziness”.

Many experts argue that by directing more fiscal resources to areas that directly benefit households, such as healthcare, Beijing could stimulate economic growth.

Analysts will be looking for new stimulus measures to spur consumption, especially any targeting social welfare, at next week’s annual meeting of China’s rubber stamp parliament. Chinese government ministries did not respond to a request for comment.

“The lack of insurance coverage against [health crises] probably remains an important driver of precautionary savings,” said Eswar Prasad, professor at Cornell University and senior fellow at Brookings.

Despite China’s growing wealth, the proportion of families suffering catastrophic health expenditure has risen.

The Lancet study found that 21.7 per cent of households suffered catastrophic medical expenditure in 2018 as measured by out-of-pocket health spending greater than 10 per cent of total household consumption, up from 20.4 per cent in 2007. For rural households, the increase was sharper — to 27 per cent from about 18 per cent over the same period. Overall “medical impoverishment”, a measure of how many people were driven below the poverty line by catastrophic healthcare expenditure, was steady at about 1.9 per cent in 2018, but rose slightly for rural residents.

By contrast, the global average incidence of catastrophic health expenditure of 10 per cent or more of total household spending was 13.2 per cent in 2017, the Lancet study found. In Russia and Malaysia, two countries with similar per-capita GDP to China, the ratio was 7.7 per cent and 1.5 per cent, respectively.

The causes of this rising incidence of catastrophic health expenditure are complex. China has been investing in healthcare at a higher rate than GDP growth. Life expectancy rose from 64 years in 1980 to 79 in 2022, according to World Bank data, matching that of the US.

But this has also increased demands on hospitals, driving up medical costs.

Doctors are requiring patients to undergo more expensive diagnostic tests, while patients are staying in hospital even for minor conditions. Hospitalisation rates had soared to levels 40 per cent higher than the global average, researchers said.

“Insurance coverage is expanding very fast but not fast enough to catch up with health expenditure growth,” said Yip of the Harvard School of Public Health.

Medical insurance in China, which is primarily administered by local authorities, does provide coverage for catastrophic healthcare expenditure but the quality of coverage varies depending on location, with wealthy cities such as Beijing and Shanghai able to fund much better care than rural areas in the poorer west. Coverage also varied between inpatient and outpatient treatment, Yip said.

To pay soaring medical costs, some patients have turned to crowd funding, though some such schemes have attracted controversy.

Last year, an online crowdfunding platform operated by Nasdaq-listed company Waterdrop, which is backed by internet group Tencent, was forced to recover funding from a 29-year-old cancer patient who had proudly showed off a newly purchased apartment to his followers after receiving donations. Waterdrop did not respond to a request for comment. Others have fallen victim to scams, in which families are persuaded to invest in funds with the promise that it will be matched by donors and deliver high returns.

Zhang, the mother of a seven-year-old boy suffering from leukaemia, moved to a town near Beijing from Inner Mongolia so he could be treated in the capital.

Government healthcare plans cover only 20 to 50 per cent of the boy’s treatment. The family’s only income is from the father, who does low-paying takeaway food delivery and odd jobs. With healthcare costs of up to Rmb10,000 per month, the family borrowed money to invest in a donation scheme. But the organiser disappeared with the cash. “It’s really tough now. If we don’t treat our son, he won’t make it,” said Zhang, who asked to be identified only by her surname.

The family of Xiang, a father from western Sichuan province, was cheated in a similar scam while raising money for his eight-year-old son, who is being treated at a Beijing hospital for two rare blood diseases.

Speaking in their barely furnished apartment on the capital’s outskirts, where his wife sprays visitors and supermarket deliveries with alcohol to protect their child who has low immunity, Xiang said they spent Rmb700,000 on a bone-marrow transplant in 2022. But after the boy contracted Covid in 2023, his body started to reject the transplant.

They now spend Rmb5,500-Rmb6,000 a month on medical bills and rely on relations for financial help.

“It’s not just our family — across China, there are millions of households with someone suffering from a serious illness,” Xiang said.

Back in Mashihaiwang village, Wang and Yuan said their three children try to help them financially but are also short of money after losing their jobs in China’s real estate crash. Wang raised some cash from a crowdfunding website, but the couple need more. “If there isn’t enough money, then just let it be,” Yuan said. “There’s nothing to be done about it.”

OREGON, USA — After Washington state's health agency said sensitive personal data was shared with federal immigration authorities without its consent, Oregon could be next.

The federal government has given the state until July 30 to comply by handing over personal information from the Medicaid-funded Oregon Health Plan, according to The Lund Report.

Washington state's health agency, the Washington State Health Care Authority (HCA), shares Medicaid client data with the Centers for Medicare & Medicaid Services (CMS), as required under federal law — but CMS turned that information over to the Department of Homeland Security (DHS) without notifying the state.

The ACLU of Washington and Gov. Bob Ferguson condemned the move, with Ferguson stating, in part, "President Trump is targeting vulnerable Washingtonians to continue to sow chaos and fear. We are looking at all available options to protect the people of our state."

The Oregon Health Authority did not respond to a question from The Lund Report on whether or not it intends to comply, only saying it will continue to "evaluate" the request.

This comes on the heels of an internal memo and emails obtained by the Associated Press, showing that top Medicaid officials fought to block the transfer of any of that kind of data to immigration officials, citing legal and ethical concerns, but two top advisers to Health Secretary Robert F. Kennedy Jr. ordered it to be handed over to the Department of Homeland Security (DHS), giving officials at the Centers for Medicare and Medicaid services just 54 minutes to comply.

That included information from California, Illinois, Washington state and Washington, D.C., which all have Democratic leaders.

The idea, according to the Trump administration, is to ensure that undocumented immigrants are not receiving Medicaid benefits that the administration says is only for "law-abiding Americans."

Legally, all states must provide emergency Medicaid services to noncitizens, but seven states, plus D.C., allow noncitizens to enroll in their state's expanded Medicaid program with full benefits. Those states launched the programs during the Biden administration, saying they would not bill the federal government to cover those costs for noncitizens.

But the Trump administration is not buying that, claiming that those programs have "opened the floodgates for illegal immigrants to exploit Medicaid, and forced hardworking Americans to foot the bill."

That's why the administration wants the data — including addresses, names, Social Security numbers and claims information for people enrolled in those programs in each state — according to the Associated Press. The move appears to be part of a broader effort by the Trump administration to provide immigration officials with more data on noncitizens and where they might be.

It also follows a move last month by the Internal Revenue Service (IRS) to share immigrants' tax data with ICE to help agents locate undocumented immigrants. U.S. District Judge Dabney Friedrich, who was appointed by Trump, refused to block the IRS from doing so.

Article text below

Wrestling legend Hulk Hogan dies aged 71, his representative confirms

First responders received a call from his Florida home at 10:00 local time over a report of "cardiac arrest", authorities say - he was pronounced dead at hospital later

Hogan, whose real name was Terry Bollea, was the biggest professional wrestler of the 80s and 90s and went on to achieve crossover fame

Tributes from the wrestling world, political sphere and Hollywood have been pouring in, with many remembering him as an "American pop culture fixture"

Known for red and yellow outfits, "Real American" entrance music, and army of "Hulkamaniac" fans, he continued wrestling well into his 50s

In 2018, he was reinstated into the WWE Hall of Fame after being ejected for using a racist slur

cross-posted from: https://ibbit.at/post/9781

From Common Dreams via this RSS feed

cross-posted from: https://ibbit.at/post/9714

The long-simmering border dispute between Cambodia and Thailand has escalated into open violence, with both sides exchanging artillery and air fire near the ancient Preah Vihear temple complex. At the time of writing, reports of what is happening on the ground are still unclear. In the Surin province, a petrol station and 7-11 were hit, supposedly by a missile, killing two civilians; a Thai F-16 fighter jet has also reportedly been downed. This latest flare-up seems to be the most serious military clash between the neighboring nations since the Cold War, reviving historical tensions that date back to colonial-era border disputes.

The conflict’s origins trace to 1962 when the International Court of Justice awarded sovereignty of the 11th century Khmer temple to Cambodia, though the surrounding territory remained contested. Periodic flare-ups occurred over subsequent decades, most notably in 2008 when Cambodia’s successful UNESCO World Heritage listing for the temple sparked nationalist protests in Thailand. The situation turned deadly in 2011 when sustained fighting killed dozens and displaced thousands before international intervention temporarily calmed tensions.

Recent months saw renewed friction as Cambodia expanded infrastructure near the border while Thailand increased military patrols in the area. In late May, a Cambodian soldier was killed by Royal Thai Army soldiers, sparking huge nationalist protests across Cambodia.

The immediate trigger for this week’s violence remains unclear, with each side claiming that the other fired first. Domestic political considerations in both nations seem to be playing a significant role, particularly in Thailand where the Royal Thai Military establishment has historically operated with almost complete autonomy from civilian leadership.

A leaked phone conversation between Cambodian de facto leader Hun Sen (father of current Prime Minister Hun Manet) and then Thai Prime Minister Paetongtarn Shinawatra last month revealed attempts at private diplomacy amid the public crisis. Paetongtarn sought to calm tensions, urging restraint, while Hun Sen expressed frustration over Thai military movements near the border.

On the call, Paetongtarn expresses her dismay at her lack of control over the Royal Thai Military at the border. She said, regarding a Royal Thai Military General, “He is on the opposite side (to her)”. This was a clear reference to an open secret in the region: that the Royal Thai Army – responsible for more coups than any other military in modern history – does not answer to a civilian parliament.

The leaking of the phone call led to Paetongtarn’s dismissal as Prime Minister by the Constitutional Court a few weeks later, severely weakening the Phue Thai party’s already fragile coalition. The pro-peasant Phue Thai party has repeatedly been ousted from government via military coup d’état in the past two decades. As such, the recent tension on the border, and outbreak of all out war, cannot be viewed in isolation as a simple state-on-state or Thailand vs Cambodia battle.

Hun Sen had ruled Cambodia for 38 years (1985–2023) before transferring power to his son, Hun Manet, in August 2023. In an oddly similar circumstance, Paetongtarn Shinawatra is the daughter of former Thai Prime Minister Thaksin Shinawatra. Both fathers are considered the real powers behind the office and historically enjoyed close family ties; it was revealed by Wikileaks that Thaksin even backed Hun Sen on Cambodia’s claim to the Preah Vihear Temple around 2009. Indeed, in the leaked phone call between Paetongtarn and Hun Sen, she refers to him as “uncle”.

However, since the leaked call – which, by all accounts, came intentionally from Hun Sen’s side – the relationship has rapidly deteriorated. Since Pheu Thai retook office in 2023 after nearly a decade of military rule, it has faced immense pressure from both ultra-nationalist military loyalists and the newly formed liberal People’s Party. Many in the military would like nothing more than to see Pheu Thai and the Shinawatra family completely expelled from Thai politics due to their pro-peasant populist policies. The recent military escalation on the border—almost confirmed by Paetongtarn as politically motivated—appears to be an attempt to destabilize Pheu Thai’s fragile coalition majority in parliament.

Similarly, it seems Hun Sen has switched sides, so to speak, abandoning any loyalty to the Shinawatras. In return, nationalist sentiment in Cambodia can be used to assuage mounting issues like currency depreciation, wage stagnation, and growing youth unemployment – while also helping legitimize the leadership transition to his son, Hun Manet.

The current clashes present concerns because of changed military capabilities on both sides. Cambodia has recently acquired new drones and artillery systems, while Thailand has invested in advanced fighter jets and missile technology – notably Saab fighter jets from Sweden. This arms build-up increases the risk that any confrontation could rapidly escalate. Several thousand civilians have reportedly already fled villages near the fighting, with border crossings closed and trade cancelled.

ASEAN has called for restraint but faces challenges mediating between member states with competing territorial claims. The regional body’s consensus-based approach makes decisive intervention unlikely unless fighting spreads to other disputed areas along the border.

Historical patterns suggest that the current fighting could follow one of two paths: either a rapid de-escalation as both sides pull back from further confrontation, or a prolonged stalemate that draws in international mediators. With nationalist sentiment running high in both capitals and military establishments wary of appearing weak, the coming days will prove crucial.

At its core, the conflict over Preah Vihear dispute represents more than just a border quarrel – it encapsulates the enduring challenges of post-colonial boundaries, the difficulty of reconciling historical claims with modern realities and the sometimes invisible domestic power struggles that take place in the capitals.

The conflict has already devastated rural communities on both sides. During the 2011 clashes over Preah Vihear temple, over 30,000 Cambodian villagers were forced to flee, many losing crops and livestock that sustained their families. On the Thai side, provinces like Surin saw cross-border trade – normally worth billions annually – plummet by 60% during tensions, starving markets that thousands depend on.

Landmines remain a grim legacy, with uncleared fields, and reportedly new mines, still claiming limbs and lives. Both countries have militarized border zones, forcing rural families into instability, with children’s education and healthcare access often compromised. The politicization of the dispute has further marginalized these communities, as nationalist rhetoric drowns out their own day-to-day economic and humanitarian struggles. As artillery shells once again fall around the ancient temple, the human and political costs of this conflict continue to mount.

Kay Young is a writer and editor at DinDeng journal (Thailand). He has a forthcoming book on Thai revolutionary history with LeftWord Books (India).

This article was produced by Globetrotter.

The post War between Cambodia and Thailand around an ancient temple appeared first on Peoples Dispatch.

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Typically, when demand drops, prices follow. But even when the number of buyers dropped, prices kept climbing. The median price of a single-family home hit record highs in 2024, and has only continued going up. In May, the median price was $427,800 – up from $357,100 in 2021, when home prices started to climb.

At today’s prices, a family would need to earn $126,700 a year to afford monthly payments on an average home purchased in 2024, up from $79,300 annually in 2021, according to a report from the Harvard Joint Center for Housing Studies.

Economists say a historically low inventory of existing homes, coupled with sluggish new construction, is keeping prices high.

All over my are there are shit tons of new starting at $350-400k

There isn't a damned shortage. There is a shortage of affordable homes. Who is afording these is beyond me because the jobs in the area don't pay nearly enough and there can't be that many upper management / C-suite families that can afford them. I am seeing banks offering Zero down / no PMI like in 2008. Like they are baking another housing crash.

Snip:

The US sees the Thailand-Cambodia escalation “through the lens of divide and rule,” Brian Berletic, geopolitical analyst and former US Marine, told Sputnik.

He warned that if the conflict spirals out of control, it could add to regional conflicts the US is also playing a hand in.

“It will create regional instability, slow growth and development, and give the US an opportunity to reassert influence over the region,” Berletic pointed out.

The analyst noted that the standoff sets back the very economic and political unity China has encouraged across the region. That unity allowed many regional nations “to work out from under generations of Western primacy and outright colonialism,” according to him.

Snip:

US Senator Lindsey Graham recently slammed Ukrainian President Volodymyr Zelensky for weakening Ukraine’s “critical anti-corruption institutions” — the National Anti-Corruption Bureau (NABU) and the Specialized Anti-Corruption Prosecutor’s Office (SAPO).

Built by the West, Controlled by the West

NABU and SAPO were created under US and EU pressure in 2015, after the 2014 coup in Ukraine, as preconditions for IMF loans and EU visa liberalization.

FBI has trained and supported NABU since 2016, including joint ops that sparked legal disputes in Ukraine.

The EU Anti-Corruption Initiative (EUACI) has still been training the agencies. USAID formalized direct collaboration with NABU in 2023 to track US aid.

Why Graham Cares

NABU and SAPO's “independence” ensures Western control over Ukraine’s internal affairs.

I can't wait for this to be used in some crappy future robo-debt style scheme.