A Study On Fund-Raising Standard And Subsidy Project In New-Type Rural Cooperative Medical System

As a term of rural medical insurance system of China, the Cooperative Medical System(CMS)plays important role in meeting the demands of basic medical care, raising the standard of health and alleviating disease burden for countrymen. Historical experiences proved that the essential approach for establishing and keeping a sustainable healthy development of the CMS is to make a reasonable fund-raising standard and the subsidy project. Health insurance actuary methods and economic theories were employed, the paper analyzed data from special investigation and fee-for-service of participant farmers, and concrete execution situation of the CMS. Aimed at advancing a systemic and feasible method for establishing reasonable fund-raising standard and a subsidy project scientifically, and making suggestions for a sustainable development of the CMS.In making a certain fund-raising standard for the CMS, following approaches were employed. Firstly, the extended linear expenditure system(ELES)was used to calculate farmers ability to pay. Secondly, the relational influence factors in willingness to participate and to pay were analyzed by binomial logistic regression model and ordered logistic regression model. Thirdly, the price elasticity of demand theory was introduced to the CMS. A reasonable fund-raising standard was determined based on a synthetical analysis on farmer's willingness and ability to pay, as well as the price elasticity of demand of the CMS.In the study on subsidy project in the CMS, the multiple logistic regression model was used to analyze countrymen's choices to participate in the CMS firstly. Secondly, according to the average daily medical expenses in hospitals of different grade, meanwhile the universality of beneficiaries was consider, deductible and maximum of subsidies were estimated. Thirdly, loss distribution method was used to fit to the distribution models of admission times and medical expenses in hospitals of different grade respectively. And it is introduced to decompose extrapolation model to determine subsidy proportion.Main conclusions as following: Firstly, it is reasonable to determine a $30 fund-raising standard according to ranges of the cooperative medical treatment in width and depth. Secondly, cooperative medical mode should fully reflect the character of mainly compensating high medical expenses. Thirdly, deductible of hospitalization expenses could be $400,$500 and $800 in grade 1,grade 2 and grade 3 hospitals respectively, and the maximum could be $50000. Fourthly, subsidy proportions are designed according to loss distribution model.Relationships among economic development level, countrymen's insurance consciousness and the fund-raising standard and a quantitative model between fund-raising standard and subsidy project were established in the study. They provide both basic methods and theory support for making reasonable fund-raising standard and corresponding subsidy project of different economic development levels. The findings and methods provide certain references for other areas as well.