Research On New Rural Cooperative Medical System From The Demand Of Peasant Households

China is a leading agricultural country with 2/3 rural population. The overall effectiveness of our medical system reform may to a large extent, be influenced or even determined by the success or failure of the rural medical system reform. However, our rural medical system is still weak presently that the lack of rural health personnel, poor infrastructure, serious infectious and local diseases as well as "leading or returning to poverty due to illness" are still prominent.Therefore, it is imperative to establish a new rural medical cooperative medical system (NCMS), and research based on it from the demand of peasant household is of great significance. In its 50 years development, cooperative medical system has gone through the embryonic stage in the 1940s, the start-up phase in the 1950s, its peak stage in the 1960s to 1970s, disintegration in the 1980s as well as restoration and development since 1990s. With China’s continuous economic and social development, more and more people began to realize that issues concerning "agriculture, countryside and peasants" are fundamentally important to both our party and our country.The research on NCMS in this report includes three aspects:First, from the perspective of historical changes, exhume the logic and potential law of NCMS’ development through the exploration of rural medical development course. Second, analyse the major factors affecting peasants’ needs for medical care by using Ordered Probit and Dual Probit model, and then make a further analysis on the effects of major institutional factors on peasants’ needs. Third, build a evaluation index system of peasants’ medical burden by using Tobit model and make case analysis on the factors of peasants’ medical burden from three investigational areas, lastly, make a comparative analysis on the different effects of new rural cooperative medical system on peasants with different levels of illnesses.By researching, this report shows that there is a close relation between the level of economic development and the age structure of peasants participants. Economic development is an important factor which influences age structure that aging population is larger in the economically developed area than that in those developing areas, thus the age structure of its NCMS members is of corresponding aging tendency. In the same environment, the more serious of aging tendency, the greater the likelihood of the residences’ illness and thus the compensation paid by the NCMS is more, and the risk the NCMS foundation takes is greater. Therefore, economically developed areas is of greater urgency in the foundation adjustment of income and expense according to the age structure of peasants participants.Secondly, medical service is a necessity with low elasticity coefficient to peasants, physical health statu is a decisive factor of producing the demand for medical services, lower household income levels and high prices of medical services will restrict the release and content of peasants’ demands for medical services; NCMS’ fund-raising standard and structure only have effect on timely medical treatment of minor illnesses but have little effect on timely medical treatment of major illnesses,which shows that NCMS’fund-raising standard and structure have little influence on peasants’ demands for medical services, especially on those with major illnesses; While the compensation rate of NCMS not only has effect on peasants’ choice of medical institution,but also has effect on peasants’ satisfaction evaluation, which indicates that a fixed institution of compensation is attractive to peasants to make a medical choice,the higher the compensation rate is, the higher peasants’ satisfaction evaluation is.Finally, the fund-raising standard, structure and compensation rate won’t reduce peasants’ medical burden with major illnesses, but will aggravate the medical burden of those with oridinary illnesses; Though NCMS activates the potential medical needs of part of the peasants with oridinary ilinesses, it nearly has no effect on most peasants with major illnesses who truly need medical services.In summary, the NCMS, since its promotion from experimental unit in 2002, has achieved obvious and rapid success. Not only has the number of NCMS members increased, but the urgent condition of lacking medical resources in rural areas has been alleviated for it better meets the medical needs of rural residents. However, the NCMS has yet to be optimized and the adaption to new regulatory environment under which the funding-raising and compensation mechanism, management and regulatory system all have been adjusted specifically is the key to success.For further development, the NCMS has to focus on the changing exterior environment as well as to make timely and appropriate policy adjustments accordingly. The research aims to improve the fund-rasing environment,legal environment, institutional enviornment and the implementation of the environment from the government’s financial, legislative and institutional aspects, and provide valuable policy recommendations for the further release of the real needs of peasants for medical care and reduce their medical burden.