Study On The Disparity Of Chinese Multi-track Social Medical Insurance In Perspective Of Fairness

Being cared of in sickness is the sign of the progress of human civilization. Perfect medical insurance system is the fundamental way to achieve this goal in modern civil society.China’s Social Medical Insurance System has played an important role in satisfying citizens’ medical requirement and protecting the rights of citizen’s health. Through the long-term exploration and development, up to now, it has established a multi-track system of medical insurance which is supported by Public Servants’Medical Insurance System(it is usually classified to Urban Employee’s Basic Medical Insurance System nominally), Employee’s Basic Medical Insurance System, Urban Residents’ Medical Insurance System and New Rural Cooperative Medical System. At the same time, this medical system has achieved the complete coverage of medical insurance basically.However, the differences between the above four medical insurance systems are huge, the prominent justice problem restricts the full realization of medical insurance’s function and the state of being cared of in sickness.Based on the fairness view of health care, centering on the indicators of participating in medical insurance, medical insurance payment, funds orchestrating and spending, insurance coverage, insurance reimbursement, information symmetry, additional costs, administrative service quality, medical resources allocation and the actual insurance effect from the dimension of dominant fairness and Implicit fairness, the author did an research on the Public Servants’ Medical Insurance System, Employee’s Basic Medical Insurance System, Urban Residents’ Medical Insurance System and New Rural Cooperative Medical System which makes an contrastive analysis between different systems and explores the fairness behind those systems through Literature Research and Field Research.Through the contrastive analysis, we found that the disparity of the current multi-track medical insurance system are huge in china, inevitably, the fairness problem is still outstanding. The Public Servants’ Medical Insurance System is obviously better than the other medical insurance systems in the dimension of treatment level; the treatment of The Employee’s Basic Medical Insurance System is better than the Urban Residents’medical insurance system and the New Rural Cooperative Medical System, but it still has a big disparity comparing with the Public Servants’ Medical Insurance System; the Urban Residents’ Medical Insurance refers to the design of the Employee’s Basic Medical Insurance System, but the treatment is lower than the former; the New Rural Cooperative Medical System has the largest population covered, however, the insurance level is the lowest and has a huge gap with other systems.Based on the conclusions above, this paper is committed to discuss the influence brought by the huge difference of current multi-track medical insurance system from the dimension of the citizens’ medical satisfaction, social equality and justice, the efficiency in the utilization of medical resources, social harmony and stability, the operation of the health care system, the reforming difficulty, the function of the medical security, labor allocation, social mobility and so on. It also explores the causes of current situation from the angle of historical restriction, the basic national conditions, the household registration system, and the right game. At last, the author trys to put forward the path of Chinese health care reform which could be summarised as "4321" path.