Study On The Interface Between The New-type Rural Cooperative Medical System And The Basic Medical Insurance System For Urban Residents

The barriers between urban and rural areas historically formed in our country and byits extension, the inherent limitations of the dual medical insurance system, are far frommeeting the needs of the development of the modern market economy and the urban andrural coordination. For this reason, under the background of each basic medical insurancesystem achieving full coverage in rural and urban areas, this paper tentatively makes anoverall strategic thinking on building the interface model between the new ruralcooperative medical care system and the basic medical insurance system for urbanresidents in China.By using the methods of literature research, comparative analysis, qualitative analysisand quantitative analysis, and on the basis of theories of social justice and equity in health,urban-rural integration, institutional change, and the interface mode between urban andrural areas of the social security system in developed countries, this paper comparesShanghai s new rural cooperative medical care systems and its basic medical insurancesystem for urban residents in detail from two aspects of system design and operationsituation, points out their respective problems, and then comprehensively analyzes thenecessity and the feasibility of interfacing the two kinds of system from the angle of thesocial environment. Based on the above study, this paper builds up the interfacingmacro-framework, including the pointcuts, the basic principle, the core content, and therealizing path. Under the guidance of the basic framework, taking Shanghai as an example,this paper deeply analyzes the concrete path and practice mode of advancing the two kindsof system interfacing, specifically, distinguishing programs in accordance with theco-ordination levels of compensation, distinguishing groups in accordance with the disposable income of residents, distinguishing regions in accordance with the degree ofeconomic development, and distinguishing phases in accordance with the growth of GDPper capita. Finally, this paper proposes some necessary and supporting reform measures inthe process of interfacing the two kinds of system.The main points of this paper are:⑴Interfacing the two kinds of system will break the limitations of their independentlyplaying security functions. If they maintain the status quo of closure development, bothof them cannot effectively circumvent existing problems of each and cannotspontaneously eliminate differences of each, instead, the severity of problem will beeasily enhanced and the expansion trend of the gap will be easily formed.⑵The key of studying this problem is to explore the realization of interface the two kindsof system in the respects of funding critera, financial assistance, compensation ratio.When the two kinds of system interface, it should fairly and consistently provide urbanand rural residents the right to participate in the insurance, protection content andcompensation directory. Under the premise of ensuring the equalization of the benefitbetween urban and rural residents, may allow the existence of the appropriatedifferences in payment standard, government subsidy and treatment level.The innovation of this paper is mainly reflected in:⑴The interface between the two kinds of system should take farmers, landless farmers,and urban non-union residents as pointcuts, take proper and gradual sequence as thebasic principle, take overall consideration and dynamic interface as the core content,distinguish projects, populations, regions, and phases to reform and advance interface,and eventually realizes the goal of the co-ordinate development and harmoniouscombination between the urban and rural medical insurance systems.⑵Based on the homogeneity and differences reflected in Shanghai s two kinds of systemin aspects of policy design and operation situation, and take the interface necessityfrom the angle of social environment into consideration, this paper sets up the guidinginterfacing framework, deeply analyzes the specific model of interfacing Shanghai stwo kinds of system, and acquires reference data of achieving the interface in theaspects of payment standard and compensation level.