The Research On Medicare Integration Of Urban And Rural Residents In China

The integration of the basic medical insurance system for urban and rural residents is a major project benefiting the people’s livelihood.In improving people’s livelihood and innovating social management,the report of the 18 th national congress of the communist party of China(CPC)clearly proposed to promote the overall development of the urban and rural social security system,integrate the basic medical insurance system for urban and rural residents,and build a comprehensive social security system covering both urban and rural residents.The 19 th CPC national congress also proposed to improve the unified medical insurance system for urban and rural residents.On January 3,2018,the state council printed “the opinion of integration of urban and rural residents basic medical insurance system " on the [2018] No.3.According to the whole,basic,multilevel and sustainable rule,the “opinion” requests that we should strengthen overall coordination and top-level design,following the principle from easy to difficult,and promote the integration of medical insurance for urban residents and the new rural cooperative system,so we can gradually establish a unified urban and rural residents health care system across the country.We will ensure greater fairness,better management of services,more effective use of medical resources,and promote the sustainable and healthy development of the universal health care system.In July 2018,the national health insurance bureau with the ministry of finance,the ministry of human resources and social security and the national health committee jointly issued <Notice on completing the work of basic medical insurance for urban and rural residents in 2018>,which makes unified arrangements for key annual medical insurance programs for urban and rural residents for the first time the national level from the perspective of urban and rural planning.The state has repeatedly ordered and relevant departments have actively promoted it,which proves from the side the integration of the basic medical insurance system for urban and rural residents,which has proved from one side that the integration of basic medical insurance system for urban and rural residents has strong practical significance in protecting citizens’ health rights and interests,ensuring people’s livelihood,promoting social equity and justice.The research methods adopted in this paper include quantitative and qualitative,empirical and normative analysis.By analyzing the problems of the basic medical insurance system for urban and rural residents since its implementation,this paper summarizes the experience of the basic medical insurance system for urban and rural residents in some regions,and probes into some countermeasures for the integration of the basic medical insurance system of urban and rural residents in China.The paper is divided into the following parts:Part one: the general theory of medical insurance integration of urban and rural residents.First,it defines the basic medical insurance system for urban workers,the new rural cooperative medical service system,the basic medical insurance system for urban residents,medical assistance for urban and rural residents and the integration of basic medical insurance for urban and rural residents.Secondly,it analyses the necessity of integrating basic medical insurance for urban and rural residents in China.It is the topic of the theory of the socialist view of people’s livelihood with Chinese characteristics,the inherent requirement of realizing the health and equity of urban and rural residents,an inevitable requirement for the development of the social medical security system,and a need to manage and realize the goal of medical security.Thirdly,it discusses the feasibility of integrating basic medical insurance for urban and rural residents in China: The current basic medical insurance system for urban residents is consistent with the design principle of the new rural cooperative medical system.Steady improvement of residents’ participation rate lays the foundation for the integration of the basic medical insurance system for urban and rural residents.Local exploration provides practical experience for the comprehensive implementation of the integrated basic medical insurance system for urban and rural residents.The people’s growing need for a better life is the impetus to integrate basic medical insurance for urban and rural residents.Part two: the analysis of the current situation of the integration of basic medical insurance for urban and rural residents in China.First,it summarizes the four achievements of the integration of medical insurance for urban and rural residents in China,including the whole promotion of medical treatment level for the insured;The management of medical institutions is more standardized and detailed;Medical insurance management departments make more rational use of information resources of urban and rural residents;Instant settlement of out-of-town medical treatment enables urban and rural residents to enjoy more equitable medical security rights.Secondly,it points out the four problems faced by the integration of the basic medical insurance for urban and rural residents in China: There are implicit unfair constraints in the integration process of the basic medical insurance system for urban and rural residents;The integration of the basic medical insurance system for urban and rural residents lacks reasonable and sustainable finance and payment mechanism;It leads to a service disconnect during the integration of the basic medical insurance for urban and rural residents;The limited level of primary medical insurance leads to poor out-patient coordination.Thirdly,it analyzes the reasons of the problems faced by the integration of basic medical insurance for urban and rural residents in China: Unbalanced Economic development is the bottleneck of the integration of the basic medical insurance for urban and rural residents;Unbalanced allocation of medical and health resources in urban and rural areas;The subjective initiative of local government is not enough;The imperfection of medical legal system becomes the weak part of the integration of the basic medical insurance for urban and rural residents.Part three: Improve the thinking on the integration of basic medical insurance system for urban and rural residents in China.First,it puts forward the goal and path of the integration of the basic medical insurance system of urban and rural residents in China: the goal is to establish a unified national health insurance system covering urban and rural residents nationwide.It needs three paths: First,prioritize integration of information systems;Second,optimize and integrate the agency services;Third,deepen the reform of the payment method,increase the awareness of risk prevention and strengthen analysis of fund operations.Secondly,it discusses the four countermeasures to integrate the basic medical insurance system of urban and rural residents in China: Carry out the system integration process of top-level design well;Establish equitable and stable financing mechanisms and fiscal subsidy mechanisms;Establish the transfer and connection mechanism between different medical insurance systems;Improve the coordination and guarantee mechanism of outpatient service.Looking from the practice of recent years,as an important public policy,the integration of urban and rural residents medical insurance system has a great effect on the health rights and interests of urban and rural residents.With the goal of realizing the rights and interests of everyone who will have access to basic medical and health care for urban and rural residents,from pilot projects in some regions,to top-level design at the national level,and to comprehensive implementation across the country,we have achieved certain progress,which is of great significance to ensure that urban and rural residents have equitable access to basic medical insurance,help us win the battle against poverty,and lay a solid foundation for building a prosperous society in all respects.