The Action Logic Of The Township Health Centers Based On The New Rural Cooperative Medical Reimbursement System

As an agricultural country, farmers’ Health Care directly affects China’s rural economic development and social stability. In order to alleviate the burden of farmers’ medicine and solve the problem of peasants’"becoming poverty due to illness", New Rural Cooperative Medical Reimbursement System (hereinafter referred to as NCMS) was carried out since2003. It is a system which is organized, guided, supported by government and receives multilateral financing from individuals, collective, and government. It is also a new type that the farmers join in it voluntarily with the focus on comprehensive arrangement for serious disease. The3Levels’ Rural Health Service System of county, town and village is the main delivery organization of the system of NCMS. The rural hospitals are in pivotal status in the system. They set the disease prevention and basic medical service as a whole, and they work as managers in the towns’public health administrative management. They are also the connecting link between the county hospitals and the village clinics. During the perfecting of the system of NCMS, rural hospitals are highly expected, the functions of which directly affect the implementation of the system.From the viewpoints of Institutionalism and functionalism, the thesis takes S rural hospital of Feixian in Shandong Province as an example, does an empirical study from the aspects of the institutional orientation of the New Rural Cooperative Medical Reimbursement System (the NCMS) to the township health centers (the THCs), the NCMS’utilization of the THCs and the current development of the THC. The discoveries are as follows:1. In order to realize their own benefits, the THCs which "withhold" the fund of the NCMS violate the normative orientation of the NCMS, benefit from the execution of the NCMS using their position.2. The action orientation of the THCs relates to the supervision of the NCMS. The stronger the supervision of the system is, the more normative the THCs’ action is. As long as the THCs don’t "withhold" the fund, the NCMS can benefit the people better.Technical environment and institutional environment are both effecting the environment of rural hospitals, rural hospitals realized its legitimacy and the pursuit of efficiency continuously during the process of NCMS’s implement.Rural hospitals should seize the opportunity to improve their operation mechanism, achieve the functional orientation of the government to them, coordinate the Trinitarian functions of the basic medical services, the public health service, and rural health.