Research On China’s Rural Basic Health Care System

To solve the farmers’ problem of "doctor expensive and medical difficult" is a crucial element to solve the "issues of agriculture, farmers and rural area" and realize the coordinated development of urban and rural areas, building a socialist harmonious society. Although after the reform and opening up China has accelerated the rural economic development, and increased income level of farmers, the level of health protection of farmers ill-matched with the economic development and our rural medical treatment and public health insurance are still behind of the level of urban health medical security development. In China,70% of the rural population only takes up 30% of medical resources, but 30% of the urban population have already taken up 70% of medical resources.Under the background of building a harmonious society, the new rural cooperative medical system is a kind of preferential agricultural policy applied by the Government to continually address the "Three Rural Issues". In 2002, Chinese Central Commission of Chinese Communist Party and State Councils Decision about Strengthening Rural Health Work clearly pointed out that "China should gradually establish a serious sickness dominated new rural cooperative medical system". Since 2003, there begins some experiments in some selected some counties. The new rural cooperative medical system is a major component of our Chinese rural health care system. It is organized, guided and supported by the government, referring to a kind of farmers’ independent system in which the farmers can voluntarily participate. And by raising fund through multiple channels including the individuals and governments, it takes serious illness as priority as a whole.By 2010, the National Farmer Participation NCMS number reached 835 million, the participation rate reached to 95%. As the main body of the rural health protection, the new rural cooperative medical care reflects the status of implementation of rural health insurance system. Of course, to give a comprehensive measure on health insurance in rural areas, we can not ignore other supplementary developments such as the rural public health services and medical assistance in rural parts.Many various factors influences China’s rural health protection, and from the perspective of public finance, this essay thesis mainly focuses on the government’s roles in rural health protection, and then try to explore improvement of rural health protection system path. The overall idea of the thesis begins with the concepts of rural basic health insurance and the relationship between health insurance and finance, and then clarifies how the finance influences the rural health system development, then finds out the problems through empirical research-a practical problems relating to rural health protection; and also finds out the reasons-the financial reasons for the rural health protection problems; and then solve the problems-finding solutions to the rural health protection problem in a effective way, providing possible support for improvement and development of the rural health protection system.With the empirical study, this thesis found that the factors that influence the farmers’ wish to join in the health protection insurance includes four main parts:the health of farmers, family annual per capita income and farmers’satisfaction on new farming hospital compensation standards and the satisfaction on outpatient service compensation standard. Besides, according to the research on the utilization and satisfaction rate, the thesis considered that compensation standard also played a great role in the farmers’willingness to join in the health insurance and security levels, and the most direct factor to the compensation standard is the unified accumulation capital scale.For the farmers, the medical protection problem is the a kind of economic capacity and health problem, and for rural medical and health services providers-government, the rural health protection is the financial policy of rural health issues. Therefore in this thesis Chapter 5 analyzed the rural health protection system problems and the possible financial reasons. And the analysis concluded that the whole cause consists of two aspects, one is the asymmetry between property rights and the governance powers, and the other one is the absence of government functionsFinally, through the summarization about the general patterns of the international health care, the thesis draws lessons from the foreign experience on the health care system, and then combining with our China’s actual conditions, provides four practical suggestions on the construction of the rural medical security system:the first should strengthen the government responsibility in the rural medical security system; the second is optimized construction on the rural health insurance system, the main body of the new rural cooperative medical care system; the third one is emphasizing the supporting construction on the rural health system:and the last one is to establish a multi-level rural health security systemThe author in the course uses social security theory of Marxist theory, welfare economics, social security theory, public goods theory of public economics, institutional economics theory, the information economics adverse selection and moral hazard theory as the theoretical support. And in the research methodology, the author adopts a normative analysis and empirical analysis combined, qualitative analysis and quantitative analysis combined approaches. Although this thesis takes "problem solving" as a starting point, the question that how the public finances of health care in rural areas of can be more equitable and more efficient is mainly discussed. And indeed this thesis also discusses the public finance in medical and health service marketing spending. Therefore, the thesis not only has meanings in solving practical problems, but also has some theoretical significance.The innovation of the thesis is different from other studies on factors by quantitative research analysis of peasants participation rate, but it mainly considers that the analysis on factors affecting the wish to join to better reflects the farmers’involvement motives, and from the demand point of view, this thesis discusses the actual needs of the rural cooperative medical care to explore the rural health insurance system problems, and from the financial perspective, it studies the underlying causes of the problems of existing rural health protection system. Of course, the study also has many defects and shortcomings, mainly in the empirical analysis of the sample whose size is a little small, lacking of regional differences, as well as the deficiencies of studies on urban and rural medical security system.This thesis is divided into seven chapters and the specific contents are described below:Chapter 1, Introduction. This thesis briefly describing the research background and motivation, topics of significance, research status and research methods used to determine the full structure of the research ideas and arrangements, and describes the major innovations and the existing shortcomingsChapter 2, analysis on the rural health protection system theories. This chapter firstly defines relevant rural health insurance systems, including what is health insurance in rural areas, rural health care and public health. China’s urban and rural medical and health security system of the formation; Secondly, this chapter discusses the development of a rural medical security system. On the whole, our rural health security system takes the birth of the new rural cooperative medical care system for the line, and is divided into traditional rural cooperative medical care and the new rural cooperative medical care. And then cooperative medical care system and a new system of rural cooperative medical care system were discussed; finally, the chapter summarizes the relations and differences between the new rural cooperative medical system and traditional rural cooperative medical service.Chapter 3, financial support for basic rural health insurance theory. This chapter defines the basic concepts on financial support for rural health insurance system; and then by analyzing the basic properties of medical and health products and also analyzing the supply and demand to explore how the financial impact the rural health protection system. Furthermore, this chapter deeply explores the impact on China’s financial support rural health insurance system after the Financial System Reform in China; finally, the chapter summarizes the problems of the financial support to China’s rural medical security system.Chapter 4, the empirical research for the new rural cooperative medical system. This chapter is an empirical analysis:firstly, there is a quantitative analysis based on data, mainly focusing on the factors that affect the wish to join in; and then, by interviews and questionnaires, there is a descriptive analysis based on farmers’satisfaction data about the new rural cooperative medical system serviceChapter 5, Financial Analysis on China’s rural health protection system defects. Analysis of this chapter can be divided into two parts. The first part is the rural health protection system studies, and the second part is a discussion on the possible financial causes of the existing problems for rural health insurance system.Chapter 6, the foreign model of health insurance in rural areas. After summarizing the successful experience of the mainstream of the international security model in rural health, this chapter compares the foreign medical health system with actual situation in China to seek enlightenments and references from the foreign rural health insurance system.Chapters 7, study on improvement of the rural basic health insurance of the financial system. Basing on the above deep analysis, considering the situation of our country, this chapter provides some measures and recommendations for our basic rural health insurance system.