The Running Dilemma And Countermeasure Analysis Of The New Rural Cooperative Medical System Of Chongming County

The new rural cooperative medical system (hereinafter referred to as "the new rural cooperative") is a hot research topic in the field of social security today. Strengthening the research,it will help to explore a new model of rural medical security that accord to the basic national conditions of China to protect the fundamental rights and interests of farmers. As a specific subject of implementation of this system, the government of townships should play a crucial role. As an example of Shanghai, despite it’s economic strength ranks first in the country, regional development imbalances still exist and urban-rural dual structure is difficult to get rid of quickly,so the counties of Shanghai will still need the new rural cooperative in the future for a long period of time. Chongming is the only county of shanghai, Whether the total number of participating in new rural cooperative or the agricultural cooperative proportion of the population is far ahead in all counties.How the effect it is that Chongming has implemented the new rural cooperative, how much difficulties has encountered, what dilemma exists?In order to answer these questions well, the perspective of S town of Chongming was specially selected. S town is a town that it’s economic foundation is weakest in Chongming, but at the same time it is also a big town in geography, population and the total number of participating in new rural cooperative.Researching S town as an entry point, the analysis of the running dilemma and causes of the new rural cooperative will be more profound,thus provide a reference to further improve the system design.Furthermore through this reaserch, it can also provide ideas and suggestions for S town on how to rely on it’s own efforts to crack the running dilemma of the new rural cooperative.There are three theories have been used, which is public goods theory, moral hazard theory and human capital theory. Using the public goods theory, it was analyzed and pointed out that due to the properties of quasi-public goods of the new rural cooperative, it caused some contradictions,that is the mismatch between and the financial strength of S town and the goal of the new rural cooperative,the mismatch between the medical needs of the masses have participated in the new rural cooperative and the medical resources of the town and village and the mismatch between the demand and consumption of the masses have participated in the new rural cooperative to a certain extent. Using the moral hazard theory, it was analyzed and pointed out that due to the motivation that the masses have participated in the new rural cooperative and the medical workers have to waste the fund of the new rural cooperative wantonly,it caused the phenomenon of excessive consumption and illegal practice of medicine to a certain extent, resulting in the mismatch between the fund expenditure and financing scale of the new rural cooperative. Using the human capital theory, it was analyzed and pointed out that since the human health is also an intangible capital and economic development boosters, the new rural cooperative is not only related to medical security but also closely related to the strategic objectives of Shanghai that is "adjusting structure,boosting domestic demand, promoting transformation". Shanghai and Chongming county should increase investment in the new rural cooperative in order to effectively alleviate the dilemma the townships have faced, whose financial burden is too heavy and the medical resources is severe shortage.The research methods combining statistical analysis and case analysis with document analysis were used. By collecting the large amounts of data of Shanghai and Chongming county, statistical analysis is used to verify the running dilemma of the new rural cooperative the S town faced. Searching plenty of literature and policy documents by literature analysis, the research on aspects of the new rural cooperative,medical security and medical markets of domestic and foreign scholars was not only summarized, the strong theoretical support to the causes and countermeasure analysis was but also provided. Using case analysis of S town as research perspective, the common problems and shortcomings in the running process of the new rural cooperative medical system of Chongming county was concluded.Through the search it was found that due to the the dual role of the objective conditions and policy factors, S town is facing four problems,which is the revenue and expenditure of the fund has imbalanced,the financial burden of S town and it’s villages is increasingly heavy, the medical resources can not meet the needs of the masses have participated in the new rural cooperative and they have not been ensured to enjoy full equality of medical power. To break the plight of S town effectively,first of all, the non-rigid fund of the new rural cooperative should be controlled in order to reduct the behavior of the masses have participated in the new rural cooperative and the medical workers of abusing fund wantonly due to the moral hazard to promote the balance between revenue and expenditure. Secondly,the income should be increased and the expenditure should be cut to reduce the financial pressure of S town and it’s villages. In order to alleviate the financial burden of S town and it’s villages, Shanghai and Chongming county should increase investment, chongming should reform the financing mode of the new rural cooperative and S town should develop its economic.Thirdly,wo should vigorously promote the equalization of the medical resources. Shanghai and Chongming county should vigorously strengthen the construction of the village clinics and the primary medical institutions and support the community health center of S town to be bigger and stronger. S town should find ways to attract and retain outstanding medical talents.Finally,the execution environment of the new rural cooperative should be optimized. The fully consistent new rural cooperative can be explored in all counties of shanghai or the new rural cooperative can be accommodated into the medical insurance system for urban residents, the medical resources distribution should also be allocated reasonably. Through the methord of market-oriented operation and redesigning payment and financing criteria, the fund can be value-added and income-added to cope with the increasing expansion of thefund expenditures. Simultaneously,some methords such as credit payment, personal account inheritance, experimenting the settlement of medical expenses outside provinces and cities, expanding the scope of relief and grants, raiseing all kinds of compensation standards and increasing the punishment on the behavior of seeking medical service to Shanghai wantonly can also be tried to promote fair and equitable between the groups which have participated in the new rural cooperative.