The impact of super-exploitation and finance-taxation barriers on the healthcare of migrant workers in China

Abstract

China's rural-to-urban migrant workers are the main engine of economic development, but notwithstanding their contributions they fall through the cracks of the marketizing healthcare system. Their plight is sharpened by wages and social security benefits which do not compare with those of registered urban workers. In response to their relegation and exclusion, migrant workers typically secure their simple reproduction in cities, while their expanded reproduction is supplemented by their rural homesteads, who raise 'left behind' children. Because this and other rural supplements to migrant workers' reproduction are appropriated by capitalists, migrants' exploitation is proportionally greater than that of their registered urban counterparts, and so counts as super-exploitation. Scholarly work commonly attributes the healthcare problems of migrant workers to their lack of urban household registration, together with inequality of social distribution (primary and secondary), and so current solutions tend to emphasize (1) Reform or rescindment of household registration in order to facilitate universal social security entitlement without precondition, (2) Increasing wages (primary distribution) and (3) Implementing medical insurance for migrant workers (redistribution/secondary distribution), though not for their families, be they rural or urban based. But these solutions mainly focus on migrant workers in cities, while overlooking the rural supplement. Domestic labor goes unpaid, and expanded reproduction undercompensated. Since healthcare is a necessity for labor power reproduction, for which the site and calculating unit is (in the case of migrant workers) typically the household, if we wish to alleviate migrants' healthcare problems we must examine the economic relations between individuals (migrant workers in cities) and their rural-based family households. By examining these relations we discover that migrant workers' healthcare woes stem fundamentally from (1) regional/provincial barriers of finance and taxation, and (2) the structure of super-exploitation.