The Research Of Vrban And Rural Medical Insuranoe System Integration In Shandong Province

Being a hotspot issue of social concern, the Medicare system has a very close relation with all residents’ health issues, and it has already been a powerful guarantee for social stability. With the improving of China urbanization, and the indistinct of urban-rural boundaries, the defects of isolated urban-rural Medicare system is gradually showing its disadvantages and we can obviously see that it cannot satisfy the requirement for equality of social security system. Especially the paralleling of Medical Insurance for Urban Residents(hereafter MIUR) and the New Rural Cooperative Medical Insurance(hereafter NCMI) exposed too many issues to cover residents’ diversified medical demands to realize social fairness. So the carrying out of Urban and Rural Medical Insurance System Integration(hereafter URMISI) is following the trend of the time, and it means a lot for perfection of Medicare System Resolution and the realization for social fairness and equality.This paper is divided into seven sections:The first part is an introduction. It includes the subject background, significance, current research in domestic and oversea, research methods, technology innovation and inadequate of the papers. This section focuses on answering two questions: why research and how to research.The second part explains related definitions and support theories. This section explains the conception of MIUR, NCMI, and details of URMISI. Except summarizing the theory of social fare and health equality, urban-rural Medicare integration, this section also explains hierarchy theory of needs. By building a integration system of Urban and Rural Medical Insurance, it has great significance for satisfying the physical and spiritual respect demand of broad residence, and for conspicuously showing social fairness and equality.The third part is the analysis for general situation of MIUR and NCMI in Shandong Province, including insured target member, insured member quantity, financial condition, deductibles, and reimbursement proportion etc. The isolating system of MIUR and NCMI leads to institutional system division, serious waste of resources, low level overall pooling, and offside Medicare Insurance issues.The fourth part combined the present situation of economic development and policy support in Shandong Province to analysis of the feasibility and necessity for the integration of URMISI. On the point URMISI feasibility, the economy base, political base, and public opinions are enumerated. On analyzing the necessity, URMISI is embodied in highlighting social fairness and justice, distracting funds risks, coordinating social development, and urbanization process.The fifth part focuses on the investigation and research of Dongying URMISI implementation, including summarizing the specific measures of system integration, the effect achieved from integration, and the effect analysis on macro and micro level. On the aspect of macro, the effect of integration system mainly achieved in the fairness improving of Medicare Insurance System, a radical cure for double assured phenomenon, separating management from operation, and the supervision level improvement to medical treatment agencies. By the satisfaction evaluation about Dongying city, this paper analyses the effects of URMISI implementation on micro aspect. This part concludes four main factors which affect the URMISI process: the satisfaction evaluation about Medicare Insurance level, Medicare convenience, medical and service level, and system concern degree.The sixth part describes the typical pattern in developed countries and the enlightenment as indication,including the definition and characteristics of developed country medical insurance system typical pattern, indications are concluded from the efficiency and fairness of developed country Medicare Insurance pattern, and the Medicare Insurance informatization level.The seventh part proposes ideas for Shandong Province URMISI. It includes following principles to uphold while in the process of URMISI implementation. Meanwhile, handling the relation of fairness and justice, the principle of matching with local economy development, focus on realization responsible government, and the platform-building which match the URMISI are all contained in the proposes for Shandong URMISI.