A Study On The Fairness Of Integrating The Basic Medical Insurance System For Urban And Rural Residents

The State Council published "The Basic Medical Insurance System of Cities and Rural Residents" in January 2016.Up to the end of 2021,all 31 Chinese provinces have finished the integration of the health insurance system.But how efficient has the introduction of this scheme been,and has it improved the equity of the population’s healthcare system in urban and rural areas as anticipated? To get the answers,this article gives a comprehensive and positive research on the effect of integrating health care schemes in city and countryside on equity by means of a three step approach: process-result assessment.In the general analysis section,first of all,this paper elaborates on the three dimensions of fairness in the starting point,fairness in the process and fairness in the outcome,and explains the path to achieve fairness in the integration of urban and rural residents’ medical insurance system to promote fairness in the integrated region;then it will look at the benefits of integrating healthcare into cities and villages from three aspects: Promoting equal treatment in relation to Member States’ rights,promoting equal treatment in health care and promoting equal treatment in the delivery of health care.At last,this article analyzes the hidden disparities that result from the combination of the city and countryside medical care plan.In the demonstration section,we analyze and measure statistics to investigate the concrete expression of the disparity in benefit funding that arises from the combination of both urban and rural healthcare systems.The study then looks at how PSM-DID is applied in the China Health & Retirement Survey(CHARLS)for 2015-2018.Effects of the policy on the use of healthcare services and the fairness of the healthcare system in two aspects.The study concluded that: firstly,in terms of financing benefits,the integrated urban and rural residents’ health insurance system does have the phenomenon of inequitable contribution burden and inequitable health insurance benefits between urban and rural residents,and the integrated health insurance fund has the reverse distribution effect of rural areas "subsidising" urban areas.Secondly,in terms of medical service utilisation,the integration of urban and rural medical insurance policies is conducive to reducing the inequality of opportunity caused by the differential medical insurance system between urban and rural areas,alleviating the inequality of opportunity of 35.3% in outpatient medical services and 26.8% in inpatient medical services for urban and rural residents respectively,which has certain policy effects.Thirdly,in terms of residents’ health,the integration of urban and rural health insurance policies is conducive to reducing the degree of inequality in residents’ health and narrowing the urban-rural health gap by significantly improving the health level of rural residents,thus promoting health equity.Finally,we suggest that we eliminate double enrollment obstacles for both urban and rural families,facilitate family registry and improve income-related funding mechanisms so as to reach the general goal of providing cover in a sustained and steady way.Second,increase the level of spending on health care to improve equity in health care.Second,improve equity in health care delivery,improve capacity and remuneration for primary health care,strengthen supervision and management of health establishments and establish a stable and effective control system.To improve the healthcare system,it is necessary to increase the level of payment and introduce differential compensation.In parallel,rural health needs to be improved,with a special focus on older people’s welfare,improving the state of health of low-income people and reducing health inequalities.This paper’s major features and innovations are as follows: At first,we adopt a three step approach to evaluate the effects and challenges of integration of health insurance system in both cities and villages in a more comprehensive and multidimensional way.A combination of both generic and empirical studies has been carried out to evaluate fairness in the utilization of healthcare services and health outcomes through a combination of both a fair and a poor one,so that the overall analysis can be more persuasive and reliable on a theoretical basis.