Farmers Cooperative Medical Needs Analysis

Since 1990's diseases have become one of major reasons resulting in poverty in rural China with the rapid growth of medical expenditures. It is an urgent task that rural medical security systems be established as soon as possible in order to improve availability of rural medical service. Due to the imbalance of economic development in different regions of China, it is not possible to establish a unified rural medical security system at present time. Therefore, the current policy is defined to develop Cooperative Medical System (CMS) based on community financing.Funds collection is one of major problems to be resolved during the course of establishing CMS. After the collapse of rural collective economy, investment on CMS by villages has decreased fast and rural households become major fund contributor for CMS. Under such financing structure the stability and reliability of CMS funds depend greatly on rural households' ability to pay and willingness to pay for CMS. The former refers to rural households' objective ability and the latter refers to subjective willingness to participate in the system. Only rural households have ability to pay and willingness to pay at the same time can CMS run on a sustainable base. In other words, the sustainability of CMS depends on rural households' demand to a great extent. This dissertation puts emphasis on analyzing rural households' ability to pay and willingness to pay for CMS and by testing the inconsistence between them concludes that rural households' demand for CMS is insufficient. After explaining this phenomenon, this dissertation puts forwards feasible patterns of rural medical security systems conforming to the socioeconomic condition of rural China and rural households' demand at present stage. The main content of the dissertation is generalized as follows:Chapter one introduces the basic theories and models of health insurance. Because criterion of insurance is introduced into CMS after economic reforms, theories and models related to the demand for health insurance can be used to explain rural households' demand behaviors for CMS. In this chapter the basic theories of health insurance demand are first expounded, then the method of measuring ability to pay and models of willingness to pay for health insurance are introduced.Chapter two reviews the evolution of rural health care system and CMS. Great changes have taken place since collective economy system collapsed after economic reforms in rural China, exerting tremendous influence on the structure of financing and ways of operation of CMS. Therefore, CMS before and after reforms have different characteristics and explicit distinctions.Chapter three makes an empirical analysis of rural households' ability to pay for CMS. Sampling survey data is used to calculate and judge the factual ability to pay for CMS of rural households. Then aLogistic model is used to analyze which socioeconomic factors have effects on rural households' ability to pay for CMS.Chapter four makes an empirical analysis of rural households' willingness to pay for CMS. Rural households' willingness to pay is analyzed by two steps: first, rural households' willingness to participate in CMS which reflects their costs and gains evaluation of participating in the system, and second, rural households' choice of modes of CMS with different levels of premium and compensation. This chapter uses Logit model and Multiple Logit model respectively to make it clear which socioeconomic factors have effects on rural households' decisions.Chapter five explains why rural households' demand for CMS is insufficient. Empirical analysis shows that low-income rural households have lower ability to pay but higher willingness to participate and demand for higher coverage of CMS, on the contrast, high-income rural households have higher ability to pay but lower willingness to participate and demand for lower coverage of CMS. The inconsistence between rural households' ability to pay and willingness to pay results in the insufficient demand for CMS. Th...