The Study Of Participants' Benefit Equity Under The New Rural Cooperative Medical System

The new rural cooperative medical scheme (NCMS) is the medical mutual redress scheme for rural people, which is organized, guided and supported by the government, participated voluntarily by rural residents, funded by multiple parties including the individual, the collective and the government, focused on compensating catastrophic diseases. The objective of it is to reduce the burden of medical expenses of rural people and relieve the poverty for disease, according to mutual redress. The character of NCMS is to provide the single welfare package covering the outpatient and inpatient service and achieve the "low level, extensive coverage". However, the outcome of low premiums and extensive coverage is high co-payments in the rural residents' health services utilization. On the other side, in the reimbursement projects of many places, cost sharing ration is established. And with the increase of the medical expenses, the proportion of reimbursement is higher. The rich peasants are healthy, but have the stronger payment capability and more services utilization. The less income peasants' health conditions are poor, but they can't enter the scope of reimbursement of NCMS and afford the high co-payments, because of their weak payment capability. This induces that poor peasants may get less reimbursement from the foundation of NCMS and services utilization than the rich ones, under the situation that paying the equal premiums. So there exists a transfer of foundation of NCMS. The aim of the thesis is to maker a research about the economic levels, the living conditions of the families getting the reimbursements, the reimbursements and the medical expenses under NCMS, and to find the allocation of the NCMS foundation, according to scientific investigations and argumentations. And to discuss the equity of medical expenses burden between different income places and peasants and to probe into the degree, source and expressive form of benefit inequity. And to advance measures to improve the equity of NCMS, strength the medical security of the poor peasants and to give some suggestions for policy making.According to the research, it is found that:1,In the village analysis of benefit equity in Qufu, peasants in different economic level places have much difference on the possibility of getting reimbursements. The concentration indexes of outpatient and inpatient are 0.054 and 0.056. Seeing from all the peasants participating in the NCMS, the allocation of reimbursement fund is inequitable and is good for the rich area. The concentration index of reimbursement fund of inpatient is 0.047. Seeing from the peasants getting the reimbursement, the concentration index of reimbursement fund of inpatient is 0.049.2,In the analysis of the peasants getting the reimbursement in Qufu, there doesn't exist much difference on the benefit between the poor and the rich. The reimbursement fund is more concentrated on the poor and the allocation is good for the poor. The concentration index is -0.025.3,In the analysis of the peasants getting the reimbursement in Jiaxiang, there exists much difference on the benefit between the poor and the rich. The reimbursement fund is more concentrated on the rich and the allocation is good for the rich. The concentration index is 0.114.