A Study On Cooperative Medical System In Rural China

The research is proposed under the background as the following: (1) Rural Cooperative Medical System (RCMS) before the system transformation was praised by WHO, however it is criticized by WHO after system transformation. (2) Diseases have become one of the major reasons causing 90% peasants to fall into poverty in rural areas of China with the decline of RCMS (3) Government has made New Rural Cooperative Medical System (NRCMS) policy, but that policy is still in the test period.This dissertation mainly studies the institution of RCMS in China. In order to analyze the problem, we would rather search for some theoretical instruments before beginning our study. From those theories, the paper establishes the comparative institutional analysis framework. Firstly the paper analyzes the transition of RCMS by using the theory and methods of institutional analysis. Secondly the paper analyzes NRCMS. At last some relevant policy implications are suggested.The development process of China's RCMS demonstrates that the past glory of RCMS should ascribe to mutual support among various factors and the operation of balancing mechanism. However, large-scale impact caused by rules environment, will and ability change of provider and demander, lack of balancing mechanism lead to the decline of RCMS.Research shows that fund-raising, compensation and exchange of medical service are relative. Although NRCMS is far different from past RCMS, reasonable compensation mechanism and effective balancing mechanism are needed in order to ensure that policy could be carried out automatically and at low cost. Now there are still some problems to be resolved in the aspects of compensation, rural medical service system and balancing mechanism.Suggestions: (1)By the way of improving the investment in rural public health, intensifying the competition in the medical service market, building a perfect rural medical service system;(2)By using NRCMS personal lowest fund, we will open personal bank account for basic clinic service to make up the balance aftercompensation, and raise risk fund for serious diseases; (3) By applying mixture payment rule, taking advantage of the ways of controlling the medical cost of city employees through medical insurance, the third-party buyers from those cooperative medical management organizations can really play their roles.