To change, China has hard nuts to crack

China is the world's second largest economy, but for many, the Chinese dream is still far away. People have to wait too long to see a doctor. Family incomes are too low to raise and support both children and elderly parents.

That is why Premier Li Keqiang won applause when he said, "The fundamental goal of a government's work is to ensure that everyone lives a good life."

Li pledged to promote fairness and justice to "enable everyone to share the fruits of reform and development" while delivering his first government work report at the on-going national session of the National People's Congress (NPC), China's top legislature.  [Special coverage]

More than 30 years of reform and opening up has boosted national wealth, but inequality in the distribution of social resources remains, with education, medicare and care for the elderly being the "hardest nuts to crack" during the next decade.

CHINA'S CHALLENGES

Ms. Wang in the city of Chengdu in southwest China's Sichuan Province paid more than double the price for a house so her daughter would be eligible to enrol in a "key primary school" nearby.

The purchase enabled her to move her household registration, or hukou, and thus meet the policy requirement that public primary schools must admit students from local neighborhoods.

Many parents believe such "key" schools, with more funding and better teachers, are crucial for children not only getting into good high schools but also for their future prospects in life.

While parents like Wang are driving up property prices in school areas, most people cannot afford to buy a tiny room nearby.

Property prices in large cities are unaffordable for the majority of people.

An old and shabby house near the Beijing No.2 Experimental Primary School, one of the elite primary schools in Beijing, has exceeded 100,000 yuan (16,290 US dollars) per square meter.

In Chengdu, it costs as much as 20,000 yuan per square meter.

"It is not difficult for my child to enrol in a school, but it is very difficult to get access to a 'key' school," Wang said.

In his government work report, Li promised to provide quality education to the next generation and ensure all children have an equal opportunity to develop.

Ning Guiling, vice president of Dalian University of Technology, said the government should set up a more balanced and long-term system for spending on education to prevent significant disparities, especially between those among urban and rural areas.

While parents like Wang are worried about education for the next generation, the swelling elderly population is also a tough burden for China to cope with.

Mao Xinmeng, 68, in Hangzhou city in east China's Zhejiang province has been living alone since his wife passed away several years ago. With a monthly retirement insurance of about 2,000 yuan, he does not know how long he will have to wait until he can afford a bed in a care home.

Mao rarely meets his only daughter who is married and works in another city far from home. "They (my daughter and her husband) have a child to raise. Even though they want to take care of me, their income is too low for them to do so."

Mao is one of the 200 million elderly people aged above 60. The number is estimated to top 300 million in 2025.

While 10 million workers are needed for elderly care services, China only has 220,000, only 10 percent of whom are qualified, said Ma Xu, director of the institute of sciences and technologies under the National Health and Family Planning Commission.

Besides the lack of money, another challenge is that Chinese people do not enjoy equal pensions.

The monthly retirement pension for government employees is about 5,000 yuan, while for workers in state-owned-enterprises like Mao it is only about 2,000 yuan. The pension for farmers is as low as 80 yuan per month.

The government has pledged to establish a unified basic old-age insurance system for both rural and non-working urban residents and improve the way it is linked with the old-age insurance system for working people.

For many, changes may not come soon enough.

China has beefed up spending on medical reform, but it is still too slow. Violent incidents between patients and medical workers have repeatedly made the news. Some have resulted in doctors and nurses either being killed or suffering serious injuries.

Zhong Nanshan, a doctor and NPC deputy, said the tensions between doctors and patients are largely caused by less communication and a lack of interaction. Patients flood big public hospitals for good doctors and the latest equipment. The time a doctor has for each patient is squeezed.

Legislators have called for more government spending in public medical services, especially at community and village clinics.

Without a sound system to improve grass-root hospitals to meet the growing demands of the public, tensions between doctors and patients can never be solved, said Guo Yufen, a senior health official from Gansu Province in northwest China.

"People are the foundation of a nation, and a nation can enjoy peace only when its foundation is strong," Premier Li said, promising reforms aimed at sharing more equally the benefits of China's economic development.

Among the government's aims are creating 10 million more urban jobs, lifting over 10 million people out of poverty, consolidating the national basic medical insurance system, as well as giving high priority to developing education and making it more equitable.

Despite sweeping reforms, analysts warned the implementation at local level would be difficult because of resistance from vested interests of those who profit from the status quo.

"There will certainly be some people and government departments who, when deprived of power, will not be happy about the changes," said Wang Changjiang, a researcher with the Party School of the Communist Party of China Central Committee.

As the easier and more popular social reforms have mostly been implemented, China's reform has now entered a critical stage and a deep water zone, he said.

"Solutions lie in leaders' determination and top-level design. It is very difficult to translate words into actions, but if it is not done, we fail."