Study On New Rural Cooperative Medical System Of Hu County

Hu County has implemented the new rural cooperative medical scheme since 2005, which has run for more than two years. During this time, it accumulated many experiences. Meanwhile, it also exposed some problems. In this situation, if we evaluate the work in this experimental county systematically and objectively, it not only can provide some scientific basis to propel the cooperative medical scheme's development, but also can be an example for other counties to study.Financing, compensation and supervision are the core of cooperative medical system. Financing can affect some problems such as the way to pay, the level to pay and the payment portions of farmers, which will influence if the cooperative medical system can be worked normally or not. The compensation will concern some problems that influence the effectiveness of cooperative medical system. Those problems are how to coordinate the beneficial range and its intensity, how to formulate the compensate policy for outpatient service and hospitalization expenses. The supervision mechanism and its effect directly affect the problems such as the cost of medical service, the compensating proportion and so on. These problems are all related to whether farmers can be benefited by it or not.This paper starts from inspecting the vicissitude of rural cooperatives medical system. Then according to its historical characteristic in developing, the author classifies the cooperatives medical scheme as four types, which are the wartime controlling type, the community welfare type, the local independent type and the government-leaded type. Based on this, the paper analyzes the improvement as well as the existence defects of new rural cooperatives medical system.Secondly,Taking government's procedure and farmer's attitude as the main line, the author analyzes Hu County's achievements and some existence problems in financing, compensating and supervising of cooperative medical system by many means, which are as follows: (i) According to the statistical data and the related stipulation about the cooperative medical service in all levels of governments; (ii) synthesizing many scholars'achievements in this area; (iii) counting the 1,978 questionnaire-surveys'results in the year 2005 and 100 in February 2007; (iv) unifying the author's discussion with the administrator of cooperative medical scheme, the participant farmers and the doctors and nurses in hospital.The study shows that the key of successful fund raising is the governmental supports; the villages and towns'public health center and its staff are the principal part to be responsible for propaganda, and the government should play the role of coordination and supervision. On the principle that people participate voluntarily, the participating rate's highest limit is about 93%, but not 100%. While considering formulate the compensation plan, it should be beneficial for controlling medical expense and supervising the medical institution. The ownership of cooperative medical finances belongs to farmers, and the supervision subject is also farmers. Although forcing farmer participate the cooperative medical scheme obligatorily has not been mature, it can first choose some experimental sites. Besides, the study also finds that the beneficial range and the intensity is not simple the inverse-portion relations. The farmers'payment percentage to medical service is changing dynamically along with their improving income.Finally, the paper unifies Hu County's actual situation, and puts forward some policy recommendations, including (i) improve the rank of cooperative medical institution in order to organize and coordinate the work; (ii) legislate through county National People's Congress to clear about the cooperative medical scheme's financing source; (iii) raise the fund in the way of"pay by unit"patterns, and other patterns for auxiliary; (iv) on the basis of not changing farmers'10-Yuan-level, cancel the individual account to enhance the fund amount; (v) strengthen the management of all levels of the certain medical institutions to promote fair competition; (vi) re-identify the function of villages and towns'public health center, and advocate to develop specialized subject health center and the community service public health center.