Reseach On Financial Increasing Mechanism Of NCMS In Tangshan

ObjectiveTo understand and estimate the actuality of New Rural Cooperative Medical Insurance Scheme (NCMS) financing in Tangshan city, discuss ability to pay of financing body at all levels and factors effecting financing. The effective demand that NCMS reimbursed was predicted in Short-term and Mid-term after its full implementation. Based on existing systems, we explored feasible scheme on increasing NCMS funds, clearly defined the responsibilities of different financing body and set the development target of financing to provide basic information to management department of NCMS for formulating a long-term plan.MethodsThere are two following date resources: macro-data and micro data, the former can be derived from routine statistic information and the later is available from Household health interview survey in rural areas in Qian'an city and Zunhua city. The future demands for NCMS financing in Tangshan city between 2010 and 2015 was estimated in this paper through literature review method, Delphi method and predicting the demand of health insurance financing.ResultsIn 2008, the enrollment rate of NCMS is up to 94.3% in Tangshan, the total funds raised is 474.637 million Yuan, in which government subsidies accounted for 82.3%, individuals contribution 14.8% and the others 2.9%. Of the government subsidies, central finance, provincial finance, municipal finance and county finance respectively account for 50.8%, 22.5%, 11.0% and 15.7%. Per capita financing level reached to 101.5yuan, the average growth rate per year was up to 26%.The per capita municipal government subsidy to NCMS is merely 9.19 Yuan, accounting for 1.11% of local financial expenditure. However, the shares of county government subsidy to NCMS as local financial expenditure are different among counties, the largest is 1.20%, and the lowest is 0.1%.The individual contribution is 15 Yuan, which hardly account for 0.23 of per capita net income of rural residents. At present, the increase of financing is affected by government subsidies, is not related to income of rural residents.Based on estimation, in 2010, the funding will be 418.70 million Yuan in Tangshan, the per capita financing level is about 170 Yuan. To 2005, the total funds should be got to 1011.5 million and the per capita financing level will up to 380 Yuan with increase of inpatient charge per time and reimbursement rate.AdvicesThe increasing financing of NCMS in Tangshan city in future is necessary and feasible. According to the estimation, two proposals of increase financing are made. Proposal 1: In 2010, when the average financing level reaches 170 Yuan, the governments subsidize 134 Yuan, including 60 Yuan from central government, 24 Yuan from provincial government, and 50 Yuan from local government. Individuals contribute 36 Yuan. In 2015, when the per capita financing level reaches 380 Yuan, the governments subsidize 210 Yuan, including 80 Yuan from central government, 32 Yuan from provincial government, and 98 Yuan from local government. Individuals contribute 170 Yuan.Proposal 2: In 2010, when the per capita financing level reaches 170 Yuan, the governments subsidize 144 Yuan, including 60 Yuan from central government, 24 Yuan from provincial government, and 60 Yuan from local government. Individuals contribute 26 Yuan. In 2015, when the per capita financing level reaches 310 Yuan, the governments subsidize 260 Yuan, including 80 Yuan from central government, 32 Yuan from provincial government, and 148 Yuan from local government. Individuals contribute 120 Yuan.Besides, the financing level in county and the responsibilities of governments at different levels in the financing can be adjusted properly. And the financing relative increasing mechanism can be improved gradually, such as the good implement of Medical Assistance Scheme, the measures of medical expenditure controlling.