A Study On System Convergence Mechanism About The Basic Medical Insurance Of Urban And Rural Areas In Shanghai

The establishment of Basic Medical Insurance System for Urban and Rural Areas ofConvergence Mechanism is an important issue which caused widespread concern in theresearch field of Social Security in China, and is also a significant aspect to consummatethe Basic Medical Insurance System. With the fully development of market economy andthe accelerated procession of the integration between urban and rural areas, to change thesituation of urban-rural dual economic structure which built on the basis of the basicmedical insurance’s “ternary segmentation” is becoming an urgent thing. CurrentlyShanghai is not mature enough to construct a primary medical treatment, which covers theurban and rural areas and enjoys the same levels on the premise that the basic medical careinsurance system has achieves the full coverage. From this background, this paper tries tomake a tentative and systematic study on the basic medical insurance system for urban andrural convergence mechanism in Shanghai.This paper uses sociological analysis such as Questionnaires and Interviews and somestatistical analysis like Correlation analysis and Regression analysis, on the basis of theSocial Equity Theory, the Urban-Rural Dual Structure Theory and the Institutional ChangeTheory and so on, the author made an deep analysis about the policies and its actualoperating conditions of the Basic Medical Insurance System for urban and rural areas inShanghai, then find out all its manifestations and underlying reasons about the failure ofsystem cohesion.At home and abroad in the basic medical insurance system for urban and ruralcohesive basic practices and beneficial attempt is developed on the basis of the basicmedical insurance system for urban and rural Shanghai cohesive mechanism of thetheoretical model, and carries on the preliminary validation. Learnt the basic practices andattempt from the basic medical insurance system for urban and rural areas at home andabroad, the author constructs the theoretical model of the basic medical insurance systemfor urban and rural convergence mechanism in Shanghai. And finally, the author points out some countermeasures to improve the convergence mechanism according to Shanghai’seconomic and social development situations.The main points of the paper are as follows:1). Basic medical insurance system in Shanghai faced with the scheme separationbetween urban and rural areas, the closure operation problems, which have their deepeconomic roots. The development of the system itself will not cause learning andcoordinating with each other, but reinforce the path dependence. The institution transitionwill lack a endogenous power. Therefore, the government should play a very important rolein building the basic medical insurance system for urban and rural interface mechanism.2). Presently, three basic medical insurance systems in Shanghai have arrived a higherlevel. Although there are some differences exists in the financing model, funding levels,compensation programs and compensation levels, there are also similarities, and while thecommon is growing, the differences reduced. Therefore, three basic medical insurancesystems’ development have create a favorable internal environment for the convergencemechanism.3). Make the three basic medical insurance systems link up through the establishmentof platforms and multi-level medical insurance platforms. The basic system platform basedon funding levels to be low at the start, following the lower not the higher principle. Incompensation, following the growth of social health needs’ rigid principles, set areasonable standard; meet the residents’ different medical needs both in urban and ruralareas through the establishment of multi-level medical insurance auxiliary platform, anduse the health resources gradually.4). To reform the basic medical insurance system for urban and rural in Shanghai, weneed to maintain the the current security level of the rural and urban health care system.Only in this way can we solve the system interface through policy changes to address thefunding model, funding levels, compensation program, compensation standards and themanagement system.