Implementation And Development Strategies Of Medicaid In Urban Area Of China

Objective: This article based on the progress, implementation effects and existing problems of Medicaid in China's urban area, and analyzed the medical hardship of different income groups, summarized the measures and their characteristics of health security to the poor in different countries, demonstrated the systematic design principles to develop and improve Medicaid in China. On this basis, development strategies and policy recommendations to improve Medicaid are raised, for providing policy information and theory to establishment of sustainable development, comprehensive Medicaid system in China.Methods: Through literature study, it analyzed specific measures of health security to the poor in different countries, and summed up their experiences and characteristics. It analyzed the progress, implementation effects and existing problems of Medicaid in China's urban area through empirical study; studied the demand of Medicaid through analysis of the medical needs and usages of certain province's different income groups. Used Excel to input data,and used SPSS13.0 to descriptive statistical data; the five income groups method, the incidence of catastrophic health exp- enditures, the burden of families'health costs and so on were used to evaluate the use of health services and the economic burden of families'disease. It calculated the expenditure demand of Medicaid.Results: The establishment of urban Medicaid promoted improvement of China's health security and social security system, and also promoted health equality and social harmony. Since the implementation of the Medicaid, it achieved some effects, and to certain extends, eased the disease risk of the poor population in urban area. But there was still having some problems in present, to limit their own development and the effecs of health security for the poor.It studied the demand of Medicaid through analysis of the medical need and use of certain province's different income groups. Although the health service needs of different income population without too much difference, the high-income population's use of health service is very high, two weeks treatment and hospitalization rate are 164.07‰and 56.04‰respectively, much higher than the low-income population. The out-patient compensation of low-income population is only 5.9%, far lower than the other income groups; on the compensation of in-patient fees, the actual compensation ratios of different income groups are between 27.03% and 62.85%,the lowest ratio is the midlow-income group.With revenue increasing, the incidence of catastrophic health expenditure shows a downward trend; when defining standards for 30% and 50%, the highest incidence group is the low-income group. The economic risks of disease of low-income and midlow-income are more than 1, 2.47 and 1.39 respectively. The gap of Medicaid's fund demand is about 6.4 billion. To sum up, confined the targeted coverage of urban Medicaid to the minimum livelihood security population is not enough, it should be developed from serious disease relief to integrated Medicaid, expanded the financing sources and further improved the urban Medicaid system.It analyzed specific measures of health security to the poor in different countries through literature study, and summed up their chara- cteristics of different patterns. It analyzed the implications to improve China's urban Medicaid.Conclusion: Through empirical study found that our country's health security and social security system was improved by urban Medicaid, and it had made some progress and effectiveness, but in the course of impl- ementing the system, there were some problems still hinder the development of its own improved. At the same time, from the perspective of"demand side", the medical need, use and costs as well as the disease economic burden of different income population were described and analyzed, and it indicated that urban Medicaid should be further improved. It should improved the accessibility of Medicaid to vulnerable groups including the poor and promote health equality.Through literature study showed that although the contents, levels and ways of Medicaid in different countries were different, there were common feathers, namely, they put emphasis on the health security of the poor and other vulnerable groups. Therefore, through drew on the experiences of domestic and international Medicaid, it raised basic principles for developing and improving Medicaid system. Follow the basic principles in the premise, in order to overcome the existing problems of Medicaid, this article proposed the overall development ideas of the community health service center for the operation platform, expanding the coverage of Medicaid, developing integrated model, the government financing is the pillar and the society funds to supplement. And it adopted by the relevant policy recommendations to ensure the smooth implementation of Medicaid's development strategies, and solve the medical difficulties of the poor and other vulnerable groups.