Research On The Integration Of Social Medical Insurance Under The Guidance Of The Citizenization Of The Agricultural Migrant Population

The integration of medical insurance is essentially an institutional change to adjust the pattern of interests and to pursue social equity.From differentiation to integration,it is the inevitable development process of all social medical insurance system in human society.At present,the social medical insurance system of urban and rural division,group separation and regional separation has also come to a historical intersection of "must be united after longtime division".This multi coexistence medical insurance pattern has its historical inevitability and limitations.In particular,with the rapid economic and social changes,the multi coexistence medical insurance system not only increases the cost of management and reduces the efficiency of operation,but also greatly inhibits the citizenization process of the agricultural migrant population.It has become one of the shackles restricting the social and economic development.For the backward countries such as China,because of the different political system,the economic development and the cultural tradition,and the unique history of the development of the social medical insurance,the foreign medical insurance integration experience can be used for reference and unable to apply directly.In fact,the integration of medical insurance in China has to be a historical situation which is completely different from the western developed countries.For such an unprecedented social change which is about to change the vital interests of more than a billion people,the Central Committee has given a clear direction,but it also needs the practice community to practice and explore with full pioneering spirit.Meanwhile,it also requires academic circles to conduct academic research that guides or assesses practice.With the promotion and deepening of Chinese medical insurance integration "from top to bottom",its development has not stopped at the macro level of institutional change and welfare adjustment,especially after the implementation of the integration of medical insurance in urban and rural residents in the whole country in 2016.The "coordination" of the behavior subject in the micro level has become the key to the success of the integration.The key is,that the coordination or not of microcosmic subject depends not only on the quality and connotation of medical insurance after integration,but also on whether they are suitable for their needs.At the same time,in view of the urgency of the demand for the integration of medical insurance with the agricultural migrant population,and their vulnerability to the impact of the benefits of medical insurance integration,this paper puts forward a study on the integration of medical insurance in the context of the implementation of the population citizenization strategy in the current China.In fact,the integration of medical insurance and the citizenization of the population not only have the common pursuit of fairness,but also have the consistency of the goal of the long-term efficiency,and then consider many paradoxes and legitimacy predicaments facing the current medical insurance integration research,so this paper builds a population citizenization guidance with the help of problem driven research.It should be a reasonable and useful academic exploration to integrate the research framework of medical insurance.This paper with the current lack of recent efficiency targets in China's Medical Insurance integration as the logical starting point,using the survey data of the dynamic monitoring of China's floating population in 2015 investigated by the National Health and Family Planning Commision of PRC,showing the lack of medical treatment and the deficiency of medical insurance for the population of agricultural transfer,and in order to promote the citizenization of the agricultural transfer population,and explore the development logic of the integration of medical insurance,and the difficulties and obstacles faced by the rural migrant population,and finally,we draw the conclusion of the integration of medical insurance under the guidance of the citizenization of the population.In order to achieve the above research objectives,we need to solve the following three key problems.First,explain the logical relationship between medical insurance integration and population citizenization.In fact,there is a hidden reciprocal demand relationship between medical insurance integration and population citizenization.On the one hand,because the fair pursuit is basically consistent with the goal of long-term efficiency and the objective fact that the integration of medical insurance is short of short-term efficiency,the citizenization of the population can act as a recent guide to the integration of medical insurance,and it is also in line with the policy of national development;on the other hand,the integration of medical insurance can promote the citizenization of the agricultural transfer population through strengthening the urban attraction,reducing the attraction of the countryside and weakening the intermediate barriers.So it can,and should be an important push for the citizenization of the population.The practice test shows that the integration of medical insurance in urban and rural residents which is driving in China,although it is beneficial to improve the rate of civic willingness of the participants,but the overall effect is not outstanding,and this effect does not function on the insured groups of Urban Residents Basic Health Insurance,which is only reflected in the insured groups of New Rural Cooperative Medical Care.This means that the integration of medical insurance needs to be adjusted accordingly.Second,what kind of development logic can be given for integration of medical insurance to answer the guiding of population citizenization.After comprehensive considering the the research needs and constraints of reality,this paper selects the citizenization willingness of the agricultural transfer population as the explained variable.Under the control of other explaining variables,this paper empirically tests whether the improvement of medical insurance availability and the optimization of medical insurance treatment can improve the rate of citizenization willingness.The results show that the better the availability of medical insurance is,the higher the rate of civic willingness to participate in the insured subject;the better the treatment of medical insurance,the higher the rate of citizen willingness to participate in the insured subject,but the family economic conditions of the insured subject will affect the size of this force to a certain extent.Third,finding the difficulties and obstacles faced by the agricultural transfer population in the integration of medical insurance,the difficulties and obstacles mentioned here refer to the microcosmic body,especially adaptability and economic problems of the characteristic groups in the integration of medical insurance.Therefore,in the analysis of the factors affecting the type of agricultural transfer population,the model is based on the insured group of the medical insurance after the integration,to dig out many challenges that the insured groups that have not integrated medical insurance may face.The results show that factors such as age,education level,migrant scope,number of children and family economic income are likely to challenge the acceptance and attendance of medical insurance integration.While combing and answering the above three key issues,this paper also makes a necessary analysis of the related derivative problems.Combined with the current operation status and integration progress of the medical insurance system in China,this paper further proposes a medical insurance integration proposal to promote the citizenization of the agricultural migrant population,including three aspects of integration principle,integration path and integration strategy.