| Rural health care system is the important component of the whole social security system .The meaning of this research is not only the demand of the health of rural resident but also the demand of urban and rural health service and the demand of steady and harmonious development of social economy.This paper consists of six chapters. The first chapter mostly sets forth the necessity and the impendence of the topic, the localization on its existed research, and the main content, the chief opinion and the basic method of this paper. The following chapter is the research on the correlative theory of the social security system, mainly including the academic boundary about social security, health care, and rural health care, the influence from different economic theory factions, beacon character of the rural health care ,and as well as the fairness and efficiency of the rural health care. The third chapter is about the comparative analysis among various health care systems in the world. In this chapter, it shows the characters, the origin, the practice and the enlightenment of four patterns on health care involving the national, social, commercial, and saving health care systems. In succession, the fourth chapter analyzes the actuality of rural health care in China, mainly containing its problems, contradictions and obstacles to its development. The fifth part comprises the analysis on the transformation of rural health care system in China. During this part, it concretely expounds the inherent relationship among property relations, economic system and health care, and its historical development. At the same time, you can learn the history of cooperative health care and why it is difficult to reconstruct this system. Last chapter is on the reform and improvement of China rural health care, involving the existed system and its characters, and as well as different trends, primary principles, realistic choice and theoretical base of rural health care. Based on the above, we can get hold of an elementary frame and the leading policy direction in the reform and perfection our rural health care system.There may be the following several points in this research's main discovery, conclusion, innovation and meaning:1. Through the competitive research and definition again to the domestic and international concept definition of social security, announce the basic point and center of the rural Medicare security system innovation, include the rural Medicare security system in the whole socialsecurity system, demonstrate further everyone is equal in front of the social security. The concept of social security is dynamic, historical and national. However, it is not the complete security with the urban security only. It is not the complete actually social security without rural security. This thesis analyses further the concept of social security, states and defines it again and demonstrate the theoretical position and the beacon characteristics of the whole rural social security including the Medicare security. It is not only the basement and prerequisite of researching the rural Medicare security system but also the vital condition of affecting and restricting the system innovation. So, it seems to explain further that why and how to obtain the right and benefit for the peasants in China. Why haven't the peasants who contribute to the socialism transformation, industry construction and marketing economic system establishment owed the direct and effective systematic security of nation and government in the health care. Why haven't peasants sent off the forte of safeguarding for the right in the deficiency of social security system in long term?2. Property relations, economic system have strong correlation with the health care system, and the arrangement of rural health care system must adapt to rural property relations and economic system. Original research with regard to the disintegration, and difficult to resume and rebuild of the traditional cooperative medical treatment system, seemed to ignore the inherent relations and influence between rural property relations and economic system. This research shows relations between ownership and management of enterprises or system that China's rural health care not merely one's own objective reality to be certain are defined, and, China's rural health care among the system , rural property relations and economic system, have obvious dependence; arrangement and changes of property relations are determining the choice and changes of the economic system, and then have influenced or determined together the choice and changes of the health care system. The health care system was limited by (may the benefited, may the damaged too) the whole rural property relations and the arrangements and the changes of economic system, and it must adapt to or submit to set property relations and economic system , and change but changes thereupon; the arrangement of a kind of effective health care system not merely help residents to be healthy and the dissolve Of disease risk and also has helped to the stability and sustainable development of property relations and economic system that already have, but it is impossible to waver or change property relations and economic system that have already had fundamentally. The basic reason of the disintegration of rural health care system and thedifficulty of resumption is that, we had ignored the relation among cooperative health care system and property relations and economic system in theory, having chosen the system mode not suitable in practice, thus fall into the predicament of" resumed" and " rebuilt".3. Funds deduction theory of Marxism social security has its universality, but more realistic localization and contradiction. In Marx's view, no matter the capitalism or the socialism, they all need or can't be independent of social security (the funds deduction). But the deduction of funds of social security has difference: under the capitalism system, it is a deduction of surplus value and surplus labor, but it seems that it doesn't emphasize the relationship of time between deduction and individual distribution definitely. The problem of social security in socialism, Marx haven't gave a systemic discussion, but gave a definite bound to the deduction time of funds of social security, it says that you must put on "deduction" before "individual distribution" or you should put on the "deduction" first in funds of social security then carry out the "individual distribution". So we can conclude that no matter the capitalism or the socialism, the process of the deduction and itself in founds of social security dose not directly root in the individual direct incomes of the laborer; in other words, the raise or deduction of funds of social security, no matter the "tax" or the "expense", can not be represent as the expenditure of individual incomes of the laborer or the individual re-burden of the laborer in format (or in legal system). From this point, it seems can not be interpreted: why should the individual pay the tax or expense of social security or social insurance directly in modern social security system? How does the deduction put on in the so-called funds of social security? Meanwhile, it seems can be interpreted: no matter the city labor or the rural labor, the nation should put the deduction on their "working earning" or "working product" by a certain measurement before their individual distribution (this measurement seems to be uncertain and recessive), furthermore, we could say that when the workers or farmers have carried out their tax or expense obligation, they should gain the corresponding right security. Unless there is another possibility: this kind of "deduction" is fictitious, vacant and insufficient or the "deduction" is sufficient but is not sufficient for using specially. Otherwise, the labor doesn't need to pay the tax or expense of social security again.4. Emphases the adaptation of the rural health care and economic development, that is not to say the level of rural health care must be restricted absolutely by the degree and level of rural economic development. We should consider the power of the overall nationalstrength and the definition of income transfer payment sufficiently. Thegeneral researches consider that the rural health care should be corresponded with the level of rural economic development and should not developing independently separated from the rural economic actuality. This research doesn't think it controversial, but it seems have obvious defects: the security of the rural, agriculture and peasants can't and shouldn't be dependent on the level of rural economic development, must consider sufficiently or at one time the level of the national economics development and the ability of macro incomes transfer payments which is dependent by the former one (not only the gross but also the structure), must build up a scientific concept of social security as "people oriented, plan as a whole between urban and rural". The city and rural should be interactive, mutual benefit, complementary mutually, improvement together and share the welfare production of social economics development. Otherwise, overabundant emphasis on the limits and effects of rural economy development on rural social security will polarize continually the health care system between the city and the rural. It seems not to attach importance to this point in theory for many years.5.From the researches on the national health care system we can say that the establishment of a rural social security system is not depend directly on the development of productivity but depend directly on the institutional equilibrium of productive relationship. Radically, the emergence of social security system is the outcome of the development of economical society (it's the viewpoint of mainstream, and it seems not to have any demurrer in the academic world), but it doesn't mean that the social security system should or must come into being from the developed economical areas first. Furthermore, it's not certain that the extent and level of the development of productivity is the direct factor of the development of social security system. And the factor is just the distortion or variation of the productive relationship, which manifest whether the equity degree of the distribution can be adapt to social ethic, moral standard, value judgment, ideology and so on. Otherwise, it will lead to the emergence and variance of social security system. This kind of adapt or tolerance can be represent as the contradiction between labor and capital, also can be represent as the contradiction among the regions, classes, colonies and between the urban and rural. If don't recognize it, you will find it is difficulty to interpret why the modern social security system in the world first come into being in German whose development of capitalist economy is relatively behindhand but not in the developed country like England and France. In our country, there is the duality structure between the urban and rural; the rural productivity trail thecity's obviously and so does the extent of marketing, but it means that the foundation of rural social security should be lag to the city? In the city, there is the relationship or contradiction between the labor and capital, and in the rural areas, who can take the relation and contradiction with rural resident? Nowadays, to what extent, the seriousness of Chinese peasants' problems have a connection with the future and destiny of our country?6. Our country tentative new rural cooperative medical system (NRCMS) has limitation and contradiction, the choice of the China's rural health care system mode should be delegated power appropriately, we can't make it rigidly uniform. There are many contradictions between the compulsory of the government input and the voluntary of the peasants' joining, at meanwhile, raise the cost of creating system new. With stable increase of the government input to the health care system, we should make good use of the opportunity to create the legal conditions which improve the voluntary of cooperative medical system to the legal compulsory of social insurance level. It can expand the benefit coverage of the peasant insurance and reduce the standard or cost of raising funds by solving reverse choices, improve the system's efficiency. Considering the correlative system pattern choice, it should insist on adjusting measures to local conditions, allow or encourage different styles for different areas, we should avoid arranging system or selecting pattern according to the three region concepts "east, middle, west" simply, consider seriously the pooling level of the insurance and coordinate and adapt to it. Also, we should emphasize the compulsion and universality of the arrangement of poor medical aid system. Regardless the kinds of areas, we should set up and implement government-oriented rural poor household medical aid system, gain high efficiency and fairness through low input. At the same time, we should encourage and protect the development of the commercial medical insurances on policy, allow for their complementary role. And the social security system can't replace, squeeze and suppress the commercial medical insurance.
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