Analysis On The Reformation And Improvement Of The Fund-Raising System For The New Rural Cooperative Medical System

With a continuous further development of the reform in China, the issue of rural medical security stands out as one of the concerns about the countryside, agriculture and peasants, which now have increasingly aroused an extensive attention from government to academic circles. Since New China has been established, a rural medical security system, with Cooperative Medical System (CMS) as the main form, was carried out and initially solved the questions of"have no hospital","have no money to see a doctor"and"medical supplies"and effectively protected the agricultural production labor force. In recent years, however, an overall decline of CMS all over the country has thrown the majority of peasants into an embarrassment, an awkward condition without any form of medical security. For example, poverty and its repetition caused by diseases have become serious. Therefore, a series of policies and measures concerned have been successively established aiming clearly at"building up a new type rural CMS step by step", and planning that such a new system will be basically applied among peasants till 2008. As a result, a hope of"repairing"the rural CMS has arisen.In this thesis, the writer intends to adopt the method of theory applying, literature review, and data analysis, and puts the study of the funding-raising system for the new type rural CMS under a social background on the basis of historical investigation into CMS, and then makes the simple introduction to its winding development. During the process of explaining the existing situation and analyzing the overseas practice modes, the writer also puts essential consideration on capital source of the new rural CMS with an anticipation of providing valuable theoretical reference and policy ground for the design and execution of the rural CMS in details.Apart from"Introduction", the thesis consists of five chapters as"An analysis of the basic theory of medical health product","A historical retrospect of the funding-raising system for the rural CMS and an analysis of the present situation","Analysis and enlightenment of overseas medical safeguard pattern","Profits from the overseas experience, multi-channel collection for the rural medical service fund"and"Conclusion".In the part of Introduction, the writer simply narrates the present situation of city and rural medical service system, and analyzes the importance of rural medical service safeguard, then explains the reason why the issue of funding-raising system of the new type rural CMS is studied.In the first part, the writer analyzes the basic theory of the medical health product. This part summarizes the present research in the field first ; then according to the theory of public products, simply narrates the generality and particularity of the rural public products, and starting from an angle of medical demands, the writer divides the medical health products into three kinds: the medical health products with the characteristic of pure public products; the medical health products with the characteristic of the products close to public products and the medical health products with the characteristic of personal products. The medical health products are supplied in different way for their different attributes.The second part sees a historical retrospect of the fund-raising system for the new type rural CMS and analyzes its present situation. The writer introduces the evolution process of the rural cooperatives medical service system and the way of fund-raising for the rural cooperatives medical first, its medical fund collection has approximately experienced following three stages: the financial system stage which has unified leadership and the level-to-level administration from 1953 to 1979; the financial system stage with the revenue and expenditure dividing, and makes both ends meet from 1980 to 1993; and the tax distribution system finance system stage from 1994 until now. Then simply narrates the achievement which the rural medical service reform obtains, emphatically points out the questions which our rural cooperatives medical service fund collection exists, mainly has: First, the fund from the government is insufficient, and grow slowly; Second, the most of the health investment fund comes from the farmer, and the farmer income is comparatively lower and the growth is slow; Third, the public health resources distribution between city and countryside is unreasonable, the level of countryside health investment is greatly lower than the city; Fourth, the difference between the different area is obvious, affects the whole progress of the health safeguard; Fifth, the majority area lacks the community level to finance ; Sixth, we has not established the standard fund-raising system of rural cooperatives medical service system.The third part introduces an analysis of the overseas medical safeguard pattern. This part analyzes the medical services pattern of England, German, Japanese, American and Indian, and summarizes the success experience of these five countries, such as the government supports, multi-channel finances, the establishment impoverished farmer medical service rescue system and the legislation and so on, and instructs the way of the fund collection for rural cooperatives medical service. In the fourth part, we'll address to measures for that fund-raising system for rural cooperatives medical service reformation. This part simply introduces the principles which the rural medical service health fund collection should follow (risk to share principle, fair principle and volunteer principle), and proposes several reform measures taking the above principle as the instruction: First, strengthening government's responsibility in rural cooperatives medical service fund collection, making government's leading role prominent; Second, the fund for the rural cooperative medical treatment will be deducted from allowance from government in the grain productive area straightly, to reduce the cost of fund-raising; Third, complied with the farmer psychology, changing the order of finance, and innovating the pattern of fund-raising for rural cooperatives medical service; Fourth, acknowledging the disparity between different regions, and implementing different form farmer health safeguard; Fifth, displaying the function of the rural cooperatives economic organization, encouraging it to assist the member to participate in the medical insurance; Sixth, the advancement of legislation on fund-raising system for the new type rural cooperatives medical treatment system should be speed up.Finally, the writer draws the conclusion through the previous elaboration: to establish and develop the new type rural cooperatives medical service system, we must establish the fund-raising mechanism which is stable and effective, we must adhere to the risk altogether takes on, fairly is fair and farmers voluntary, implements the fund-raising mechanism which has governmental, social and individual supports . Only in this way can we guarantee the continuous and stable development of the rural cooperatives medical service system, can address the problems relating to farmer health, can enable the farmer health to have the safeguard, thereby ensuring the sustained and healthy development of agriculture and provide material guarantees to build new socialist rural areas. Simultaneously the writer proposes several questions close to this subject, which are worth further studies.