The Impact of China’s Hukou System on Social Inequality: A Focus on Healthcare  and Pension Provision

Abstract: This paper analyzes the enduring inequality embedded in  China’s hukou system, which classifies citizens by rural and urban status  and determines access to welfare, healthcare, and pension benefits.  Originating as a mechanism to control internal migration and urban  growth, hukou has evolved into an institutional barrier that restricts social mobility and reinforces economic disparities. Focusing on  healthcare and pension provision, the study explores how policy design  and local implementation continue to disadvantage rural migrants de spite reform initiatives. By comparing regional variations and examining  recent policy adjustments, it argues that most reforms remain frag mented and insufficient to dismantle structural inequalities. The paper  concludes that only a nationally coordinated and fully decoupled re form from hukou status can transform the system into a foundation for  genuine social equality in China.  

Keywords: hukou system; rural migrants; healthcare inequality; pension  access; social mobility.