Research On The Innovation Of New Rural Cooperative Medical System Towards The Trend Of Nationalwide Medical Welfare

The reform of medical welfare system has been a paradox for many countries all around the world. Because its unique characteristics from both aspects of supply and demand, the reform of medical welfare system is dedicated to be not only a kind of scheme innovation, but also a systematic innovation include rearrangement of benefit from top to the bottom as well as the balance of different benefit bodies. In China, however, the availability of medical service is a problem which has troubled people for a long time. From 2003, the government established the new rural cooperative medical system (the "NRCMS"), which has played a positive effect in satisfying the medical demand of and in easing the medical burden of peasants. However, due to the lack of medical insurance system for a long time in rural areas, there are a lot of problems and thus the NRCMS faces huge challenges. Under the guidance of the objective of the national medical insurance, it is obvious that the NRCMS is just a transitional arrangement under the urban-rural dual structure. Therefore, it must be addressed how to perfect and develop the NRCMS and coordinate it with the national medical insurance system. Furthermore, the NRCMS in underdeveloped areas is the short board in the transition from the NRCMS to the national medical insurance system, and thus how to perfect the NRCMS under the restricted resources of underdeveloped areas is of great importance and may be referenced by other areas.Based on empirical study, this thesis discussed the features and difficulties of NRCMS reform in underdeveloped rural China, and the main issue of transforming from NRCMS to total medical welfare system. Tries to address the following problems:what are the specialties and problems in the running of the NRCMS in underdeveloped areas? How to explore the contents of the national medical insurance system under particular historical culture and systemic environment in China by reference to typical foreign medical insurance modes? What new requirements does the guidance of the objective of the national medical insurance system make to the NRCMS? What are the gaps between the NRCMS in underdeveloped areas and the national medical insurance system? How to narrow such gaps and minimize the system friction in the transition from the NRCMS to the national medical insurance system? What are the order and methods which should be followed in the innovation of the NRCMS? The main content of this thesis include:the development and difficulties of NRCMS in underdeveloped areas; the goal of total medical welfare and the core of its policy structure; the execution of NRCMS in underdeveloped area and its disadvantage compared with the total medical welfare framework, and the innovating path of NRCMS towards the total medical welfare.This research has chosen Gansu province as a sample of NRCMS for its typical underdeveloped characteristics. By using combination research methods of questionnaires, individual interview and statistical data analysis the author can get a thorough understanding of the running of NRCMS. Based on the comparison with different modes of medical welfare system in other countries, as well as the review of previous theoretical studies, this thesis pays attention to the core factors for developing NRCMS to total medical welfare, in detail the fund raising system, compensation system and management system, and gives suggestion about the theoretical analysis framework of NRCMS in underdeveloped areas. Then the analysis focuses on the innovating path of NRCMS and policies, using two dimensional analyses to get the new conclusion about transforming NRCMS into total medical welfare.As conclusion of this research project, the authors is of the opinion that the innovation of the NRCMS under the guidance of the objective of the national medical insurance may be earried out in following order:firstly, considering the difficulty of implementation of management methods and technology innovation, the availability level, reimbursement efficiency and compensation equality should be improved preferentially, thus peasants can feel the advantages of the NRCMS; secondly, the supervision of medical institutions must be strengthened, especially the payment system of and the perfection of the supervision system of medical institutions, on the basis of which the reformation of medicine supply system and of the governance of public hospitals should be made gradually; thirdly, the restriction of resources in the establishment of the NRCMS and the deep-rooted traditional opinions of peasants should be changed to perfect the NRCMS constantly.