Institutional Change And Assessment Of Rural Cooperative Medical System In China (from 1949 To 1980)

Rural cooperative medical system can be called a great beginning of the 20th century in China. It was once hailed as the "unique example of resolving health fund in developing countries" by the World Bank. The author systematically summaries and surveys related research findings on rural cooperative medical system in China, and reviews its evolution of emergence, development and prosperity, and analyzes specifically four features of institutional change, including subject pluralism, periodic change, progressive process and the dynamic goals. Meanwhile, the author taking institutional environment as the breakthrough point, looks into five external factors including government's great importance, socioeconomic structure, collective cooperative economic system, select concept of public policy and media, as well as two internal factors including system efficiency and demand meet about the change of rural cooperative medical system. Then taking value orientation and system construction of idea, system effectiveness, system adaptability and system sustainability as assessment index, the author assesses specifically the change of rural cooperative medical system and draws a relatively objective and impartial conclusion: under the direction of fair value orientation and collectivistic system construction of idea, the system accommodates to the situation of China and goes with the public willingness. Moreover, it meets low-level medical health demand of peasant and promotes rural socioeconomic development, but it lacks of coordination in system structure and specification in system operation and poor system sustainability. On the basis of above discussion, the author analyzes the reasons of the decline of the rural cooperative medical system in policy, economic system and allocation of resources.