From Binary Partition To Integration: The Path Dependency Analysis On System Reform Of China's Medical Security

At present, China's medical security takes on a binary partition characteristic. There are different medical policies in medical treatments to different people, such as insurance payment standards, financial subsidies standards, reimbursement ratios and approval items. In medical field, several departments have management power, including Health Department, Social Security Department and Civil Department. It causes high cost and low efficiency problems. There are many reasons for the formation of urban-rural partition, history's initial conditions, economic, political and cultural reasons, etc. But the root reason is system. So, reforming the binary partition system and achieving the new system change have become the Party and the government's urgent task.In the document of the Views of Deepening Medical Security System, which was published in April 6, 2009, the CPC Central Committee and the State Council stressed that exploring the establishment of the integration of urban-rural medical security system was necessary. China's urban-rural integration is a new strategy in the new historical period which was put forward for the imbalance of China's urban-rural medical security system in the past 50 years since the founding of China. The key to implement the new strategy smoothly is to choose an effective path of institutional change.First, this essay applies the path dependency method and studies on the binary partition path formation of China's medical security in the period of economic transition. Second, from medical services'quasi-public goods characteristics, we discuss the internal change and the effective path of China's medical security system in the view of system association, including diachronic association and synchronic association. Finally, for the reconstruction issues of China's medical security system, we make a judgment——urban-rural integration is the target model of China's medical security reform. Through the path dependency analysis on China's medical security system, we can predict the future and find the leading role of the factors, so that people can impact the changing path in some extent.