Urban Social Stratification In China And The Construction Of Multi - Level Social Medical Insurance System

Nowadays, we Chinese people are making great efforts constructing a comfortably off society. Medical care is essential to one's health without which a society cannot be comfortably off. And it is incumbent for our government to make all the members of the society to enjoy medical care equally. To construct an effective medical care system according to the situation of our country is one of the emergency tasks in our social care system construction, and it is the most difficult one as well.Since the reform and opening-up of China in 1978, especially after entering the 21st century, the economic reform implemented by our government has brought fundamental changes to the social classes of our country. The past working class, peasantry class and intellectual class in our society before the implementation of the policy have been undergoing division and recombination and consequently some new classes came into being. At the same time, the gap between the rich and poor are getting large, the differences between the classes becomes more and more obvious, and the price of medicine keeps up and the medical resources are unequally distributed. With the background mentioned above, this thesis puts forward the topics of the division of social classes and the construction of multi-level medical care system; with economical level as the standard and base of social classes division in town and multi-level medical care system construction in present China, it provides the corresponding means for the construction of multi-level medical care system and tries to build an analyzing bridge and make a deep analysis of the inner-relationship between the division and construction.Chapter One makes delimitation on correlative concepts of multi-level medical care and introduces some present medical care modes in different countries. The medical care system has become a fundamental economic system in many countries, Owing to different historical backgrounds, economic levels and cultural traditions, the modes are different in different countries. Generally there are four kinds of modes: national medical care system; social health insurance; saving health insurance, and mainly private joining commercial health insurance.Chapter Two makes an analysis on social class changes and establishment of medical care system in China. Firstly, it analyzes social classes and medical care system in town before the reform and opening up. The establishment and development of free and labor insurance medical care system can be divided into three periods: fundamental system's foundation period (1951—1956); strengthening and development period (1957—1968); and the period of change in fare-drawing and out-coming means (1969—early 1980s). Free and labor insurance medical care system went through some modifications such as setting limitations on medicines and introducing personally minor pay system, but the general frame didn't change. Secondly, it analyzes social classes and medical care system in town after the reform and opening up. The social classes don't come into being in one day. The division is the result of long interaction among various aspects. And the process makes the revolution of medical care system go further which also has three periods: the early reform of employees'medical care system (1988—1993); the exploration of"the combination of overall consideration and personal account"medical care system (1993—1995); and the establishment of new-type employees'basic medical care system (1995—1998).Chapter Three mainly states present social classes in town and the establishment of medical care system for different classes in China. At present the classes in China are as follows: the administration class of country and society (i.e. Party and government leaders and carders), managing class, private enterprisers'class, special talents, individually-owned business people, commercial service people, industrial working class, farmers, and un-employees and half-employees, etc. There are different medical care systems for different classes. With the further promotion of reform and opening-up policy, our country modifies the present policy in time and makes some reform in medical care system in some cities and areas, preparing to substitute more scientific and more coverable medical care system to old medical care system. Chapter Four is an assumption of constructing multi-level medical care system. Firstly it concludes the achievements of present medical care system and analyzes the contradictions and problems in medical care system of China. Then based on that it puts forwards the goals, tasks and measurements of constructing multi-level medical care system. According to the present economic level of China, together with various employment situations of different people in town, with the perfection of town habitants'medical care system as the core, we should make an overall construction of town habitants'medical insurance, complementary medical insurance and medical aid system. Emphasizing serious disease security, we should construct multi-level and multi-means medical care system, and achieve the goal of including all the town habitants into the medical care system step by step.