Institutional Embeddedness And Keep-on Development Of Cooperative Medical Schemes (CMSs)Operating In Rural China

This is a study of cooperative medical schemes (CMSs)operationg in rural China from the perspective of institutional embeddedness. As a kind of community-based health micro-insurance scheme. CMSs often suffer from financial vulnerability due to its small scale of risk pooling. CMSs operated relatively successfully during the pre-reform era as the institutional environment in which they were embedded were favorable. Under the planned economy and tough social control, adverse selection and provider induced over provision of healthcare were non-existent. During the market transition, CMSs encounter with so severe problem of adverse selection that they lose attractiveness to most of rural residents, and they are further sabotaged by bad governance. At the same time, healthcare providers, driven by marketization, have no longer had incentive to certain cost increase. Chinese CMSs are at a crossroad, either developing towards a state-run voluntary health insurance scheme or maintaining its community-based nature but receiving strong support from the government.This text cooperates the medical treatment to be the planned essence content of the community money raising to set out from the village, pass as to it's the ex- planned economy system of the reform experience descend and the market turn two kinds of factors of system environment analysis,point out to cooperate the medical treatment to acquire and can keep on the development under an environment, must imbed in the feat society economic political environment in, and put forward the homologous suggestion.This text is divided into five parts on the contents:The first part introduction: The synopsis explains point of departure, related cultural heritage overview, the topic background and meaning, the research method and the way of thinking.The second part refer to theory foundation explaination of institutional embeddedness. Introduced the village cooperation medical treatment as to be the community medical treatment and its vulnerability essence.The third part turned the falling off both side that the ages cooperates the medical treatment to carry on the factor analysis from the success and markets that the reform cooperates the medical treatment to obtain before, the reform success of front is according to at that time highly political centralization system, not is to cooperated this system of medical treatment to have a certain and superior.The fourth part refer to the contrary choice problem as CMSs return voluntarily from compulsory aptitude, the key point is add attraction in the structure of paying to farmer.The fifth part according to above analysis and research, cooperate the medical treatment very weak, emphasize that it manage of to the pass importance. Manage two main aspects of structure to carry on the analysis from the cooperation medical treatment.The sixth part passes the front to develop the research and analysises of the factor and Chinese realistic social system environment to the cooperation medical treatment oneself, and combine relevant new the policy expose come out of problem, put forward the concrete suggestion.