The Investigation Analysis And Performance Evaluation Of New Rural Cooperative Medical Care System

China’s rural residents were in no social health insurance status during the periodafter the collapse of the traditional rural cooperative medical system, but prior to theestablishment of the New Rural Cooperative Medical Care. During that time, theexpenses of medical treatment should be afforded by individual rural resident. By thelate1990s, the growth rate of medical expenses had increased much faster than that ofthe income of rural residents. Rural residents could not bear the heavy load of themedical expenses, especially when they suffered from serious illness, which ultimatelyresulted in illness-related poverty. It became difficult and expensive for rural residents tosee doctors, which led to a decline in their physical health condition and seriously had anegative impact on rural human capital accumulation and social stability. In view of thissituation, in order to reverse the medical plight of rural residents, in2003, thegovernment advocated to carry out the New Rural Cooperative Medical Care--a medicalassistance system with the emphasis on serious diseases in the pilot suburbs of someprovinces and cities. It was organized, led, supported by the government, and ruralpeople participated in the program voluntarily. This kind of strategic policy can promotethe fairness of society, balance development, and benefit the rural population of760million. It will benefit the decrease of gap between urban and rural areas, reversion of thelop-sided social development structure and the construction of harmonious society in thelong run.The purpose of writing this paper is to examine the implementation andperformance of New Rural Cooperative Medical Care System and analyze the mainproblems, in order to contribute to the improvement of New Rural Cooperative MedicalCare System. The author carried out surveys and questionnaires to rural residents whohave applied to medical security in Liaoning, Jilin, Shandong, and Henan Provinces, andgrasped the actual operation of the system and first-hand information, based on which thethesis paper framework was designed and stated. The main contents are as follows:Firstly, the theoretical basis is stated. On the on hand, the paper systematicallyanalyzes and objectively evaluates the research on the problems of rural medical securitycarried out by domestic and foreign scholars. It includes foreign scholars’ research onrural medical security system, effects of rural medical insurance system on prevention ofeconomic risks, and the role of government in medical security and the failure of intervention. The existing research provides the knowledge base and reference for theresearch of this thesis paper, and the deficiency of existing research will constitute thefocus of this study. On the other hand, the paper also generally elaborates theory of socialjustice, information asymmetry, interest group theory, Pareto efficiency theory and Nashequilibrium theory. The theories provide theoretical basis on indicator selection andanalysis of causes of problems.Secondly, the paper does investigation on performance study of the implementationof New Rural Cooperative Medical Care System. First of all, the paper introduces thebasic situation of the investigation on New Rural Cooperative Medical Care System,collates and analyze the investigation data and findings. Then, according to survival andlabor justice theory and the actual situation of urban and rural medical security in China,the paper has established performance evaluation index system of New RuralCooperative Medical Care System and assigned different weights to each index. It alsoobjectively evaluates the implementation performance of New Rural CooperativeMedical Care System on the basis of first-hand and official statistics. Lastly, due to theevaluation results of implementation performances, the paper discusses the mainproblems of New Rural Cooperative Medical Care System, such as low fund-raising,limited scope of illness security, inadequate referral system, lack of supervision andmanagement, low levels of technology in designated medical institutions. Theseproblems have made rural residents face obstacles in medical needs, and contradict theoriginal designed intention.Thirdly, the paper makes an analysis on the causes of the problems of New RuralCooperative Medical Care System. On the basis of information asymmetry, interestgroup theory, Pareto efficiency theory, and Nash equilibrium theory, the thesis papermakes game analysis on system design, capital contribution obligations of operation andmanagement, supervision and management, etc, and then deeply analyzes the causes ofproblems within New Rural Cooperative Medical Care System. There are many problemsin the implementation of New Rural Cooperative Medical Care System, which are alldirectly related to the original designed deficiency of New Rural Cooperative MedicalCare System. The system aims to provide security for serious illnesses, but it can notonly satisfy the interest demand of rural residents who hope to have securities both forserious illnesses and ailments, but also contradicts choices of designated medicalinstitutions. The contradiction causes limitation of referral system, which further gives rise to new problems such as migrant workers having difficulties in seeing doctors andrural resident facing obstacles in transferring medical treatment. Local governments arein charge of the operation, management and funds of New Rural Cooperative MedicalCare System, but the performance appraisal is still a DGP-oriented, therefore, localgovernment does not take both charge of funds and management, and responsibilities andrights are not consolidated. These problems cause that local governments are deprived ofinner force for the management of New Rural Cooperative Medical Care System and arelack of sufficient funds for effective supervision and management of it. With the lack ofgovernment’s supervision, it is likely to occur overtreatment in designated medicalinstitutions, and participated rural residents and designated medical institutionsconspiring apply the funds. In terms of the cooperative medical system for seriousillnesses, choices of rural designated medical institutions, management obligation andcapital system arrangement of New Rural Cooperative Medical Care System, they are allassociated with the national conditions of China’s current low level of economicdevelopment, but also depend on the force comparison among system players involved.Fourthly, the thesis paper improves countermeasures for New Rural CooperativeMedical Care System."The philosophers have only interpreted the world in differentways and the problem is to change the world." The paper concludes the causes and theexisting problems in New Rural Cooperative Medical Care System and use theexperience of rural medical insurance system in some other countries such as Japan,Britain and Germany which provide profound experience in fund raising, medicaltreatment mode, and levels improvement of medical treatment. Furthermore, the paperprovides countermeasures for the improvement of the system, which mainly suggest toestablish legislation for New Rural Cooperative Medical Care System, increasegovernment funding for the new cooperation system running, improve the level ofservice of designated medical institutions, improve the medical referral system, andstrengthen the supervision and management of New Rural Cooperative Medical CareSystem.