The Practice And Policy Research On The New Rural Cooperative Medical Care System In Shao Xing Urban District

Although we have already achieved some effects since the implementation of the new rural cooperative medical care system; due to the short period of time, there still exist a series of problems in aspects like capital raising, regulations standardization and services provision. Through methods like documentary analysis, questionnaires, topic interviews and contrastive analysis, this paper is expected to provide suggestions and solutions, and relative evidences for the government's further improvement, in accordance with the investigation of implementation of the new rural cooperative medical care system in Shao xing urban district.By interviewing the interest-related parties, we found that the major problems lie in the following aspects: there are contradictions between farmers'low health awareness and the reciprocity which the cooperative medical system asks of, low capital-raising ability and farmers'high expectations on return, voluntary participations to insurance and the demand of high insurance rate. Besides, the medical techniques and service in primary level public health clinics are still less developed, and the increase on medical fees too fast. When answering the reason of taking part in the new rural cooperative medical care system, 51.36% of the interviewees say it can help resist health risks, and 21.97% favors the reimbursement and exemption of medical fees. Among those who don't take part in, 33.38% think that their health conditions are so good that there is no need to participate and 23.91% think it not worth participating because of the low amount of reimbursement. On the level of satisfaction, 70.01% of the farmers express complete satisfaction or relative satisfaction. As for future cooperation, 90.82% express their willingness of re-participation in the next year. Take farmers participation willingness of next year as a variable, and bring 8 single elements in analysis P< 0.20 into multi-element mode. 6 elements that have statistic meaning (P < 0.05) are finally kept in logistic formula: personal income, reimbursement on medical fees in earlier times, free medical examination, the hearing of others'reimbursements through the cooperative medical system, the satisfaction and knowledge levels towards the new rural cooperative medical care system.The research indicates that rural medical security system, with the new rural cooperative medical care system the core, has been established on its initial level in Shao xing urban district. A reasonable capital raising system has been built, a compensation mode which is suitable to local economic and social developments level has been adopted and a scientific supervision and regulation system has been formed. Thus the information construction has been strengthened and the working efficiency significantly improved. However, we should notice that there are still some problems existing in the new rural cooperative medical care system, which are mainly among factors that affecting sustainable development in system setting; more emphasis on medical care than in precaution on the area of security; lack of financial investment; low coverage of the beneficiary; hidden risks in funds development; weakness in managing cooperative medical funds; lack of working solutions on supervising medical organizations; and irresistible tendency of medical fees increase. It is suggested in this paper that we should strengthen the support from laws and administrations; improve the capital raising and security abilities and incentive system; upgrade the socialization level of the new rural cooperative medical care system; try to combine the public health and cooperative medical care; further improve the management system; reduce wastes caused in the management process; establish and improve the supervising system on the cooperative medical care system; control the unreasonable increase on medical service fees; set up an evaluation system on the new rural cooperative medical care; speed up the reform on rural sanitations; and build up a new type of rural health service system.