Study On The Implementation Status Of The New Rural Cooperative Medical System From The Perspective Of The Peasants

Medical security in rural has been paid much attention in recent years.The new rural cooperative medical system has been implementated for nearly10years since2003.It has made some achievements, also faces many challenges.The status was mostly measured from the perspective of policy and implementation.This paper focused on the implementation status of the new rural cooperative medical system from the perspective of peasants, showing the real situation of the system.This paper mainly used two methods of research:qualitative research and comparative method. Qualitative research method was used in this process:related data were colleced by interviews, and were transcribed and coded for analysis of the running status of the new rural cooperative medical system. Comparative research methods were mainly embodied in two aspects:one comparison was made of cognition of peasants in F city on the new rural cooperative medical system, benefit between the year2010and2013. The other comparison was made between the policy and peasants’actual benefit.The findings can be divided into three parts:The first part is about peasants’ cognition of the new rural cooperative medical policy. Although the participation rate and funding standard of the new rural cooperative medical system has kept at a high level, peasants didn’t have much acknowledge of the policy in the implementation process of policy. Most peasants believed the new rural cooperative medical policy was useful for peasnts, but they were not aware of the latest policy, the use of raised funds, coverage and standard of reimbursement. What’s more, most peasants had no motivation and ways to comprehend the policy. Although the system has been implementated for years, the peasant were still in a relatively passive state.The second part is about the status that the peasants participated and used the system.Peasants’ articipation process embodied the principle of voluntary participation Peasants mostly obtained compensation from outpatient service with a compensation ratio of20%. Only a few peasants obtained compensation from inpatient service, with a compensation ratio under50%which was required by the proportion of policy. There was even a part of the peasants who had never used the new rural cooperative medical services.The behavior that one used other people’s cooperative medical certificate for outpatient service compensation is irregular but reasonable. The majority of peasants were skeptical of designated medical institutions and designated drug stores in2010, while more people used the service of new rural cooperative medical system in2012. There were two reasons.One was the propaganda of acquaintance network, the other reason was the price of drugs declined in village health room with the implementation of the basic drug system.But some of the villagers didn’t trust the system,they didn’t use the new rural cooperative medical service with the consideration of convenience and personal relationship.The third part is the problems existing in the implementation process of the new rural cooperative medical system. The financing mechanism that peasants in one household was an financing unit led to duplication fees. The new rural cooperative medical system was not perfect, so the reimbursement procedures were neither transparent nor stable.The overlap of regulator institutions and the regulated led to ineffective supervision. Because peasants had a little acknowledge of the new rural cooperative medical system and insufficient participation, they were still in a status of weak power. Primary medical institutions were not equipped with enough drugs and equipment,so they could not meet the medical needs of peasants. The implementation of drugs non-profit policy reduced the pay for doctors and other people in primary health care institutions and affected the quality of service they provided.This paper discusses the actual problems in the implementation of the system.and puts forward the relative countermeasures from the aspects of the development direction and specific policy proposals.