Illustration: Lu Ting/GT

According to a recent blue book on health conditions among migrant construction workers in Shanghai, over 50 percent of these workers suffer from injuries, respiratory diseases or digestive disorders.

But despite the prevalence of ailments within this group, only 35 percent of sick or injured workers will see a doctor for medical attention. Moreover, a full 67 percent of migrant workers have never had a physical examination.

Such figures show that migrant workers in Shanghai are still falling through the cracks in the city's healthcare system. Clearly more can be done to expand access to medical services within this population.

Migrant workers in big cities are vulnerable to several forms of exclusion when it comes to accessing medical treatment. Cost is one of the biggest barriers, since many migrants simply cannot afford medical treatment in an expensive city like Shanghai.

In fact, local media outlets have reported on several occasions about the rise of illegal, unlicensed clinics which cater to migrant workers looking for cheap treatment.

Meanwhile China's hukou (household registration) system presents another barrier. Without a Shanghai hukou, migrant workers cannot enjoy the same healthcare entitlements as local residents.

According to a report by the Shanghai Municipal Statistics Bureau, 20 percent of migrant workers in Shanghai do not have any healthcare insurance while only 35 percent are covered by the New Rural Cooperative Medical Care System in their hometowns.

This means the vast majority of migrants can only get reimbursed for their expenses if they go to hospitals in their hometowns.

Of course, social exclusion is another factor at play. Even urbanites complain about how complicated it is to receive treatment in local hospitals, especially when specialized treatments and procedures are involved.

While Shanghai natives can use their social networks to locate a good doctor or a hospital bed, migrant workers usually do not have the connections.

While a universal healthcare system might be too ambitious for now, I think Shanghai should at least push forward a scheme to accept New Rural Cooperative insurance at local hospitals.

Such a scheme should also avoid complicated paperwork and make reimbursement quick and easy. Perhaps the city could first introduce a trial scheme aimed at migrant workers from the Yangtze River Delta region and then expand the program if it bears fruit.

Moreover, the local government should offer affordable medical insurance plans tailored to the needs of migrant workers, most of whom in their 20s, 30s and 40s; an age group that is less likely to suffer severe illness but still prone to non-life threatening ailments and injuries.

The government should also be responsible for educating migrant workers about the necessity of insurance. Many migrant workers are not willing to sacrifice their income on insurance.

When illness strikes, they would rather trust their co-workers or their own judgment and endure the sickness rather than pay for professional treatment.

Municipal authorities should also build more community-level clinics aimed at migrant workers in areas that have dense migrant populations, such as Pudong's Sanlin town.

When there are more legal, affordable clinics to choose from, migrant workers will become less reliant on illegal (and potentially dangerous) alternatives.