The Research On The Mechanism Of Government Co-ordination Of The Establishment Of The Migrant Workers Medical Insurance System

Migrant worker is a huge emerging class in contemporary in China, and this group continues to increase in number. They have made an indelible contribution to the economy development of China. However, most migrant workers in China are excluded from our medical insurance system. We should improve China's migrant workers medical security system gradually, and build the medical security system which can cover all migrant workers and suitable for them as soon as possible. It has an important significance for improving China's social security system and pushing forward the process of urbanization and building a harmonious society.China's scholars began to research on migrant workers medical security system from different perspectives from the eighties of last century when the migrant workers problem performed. We can see from the published papers that they concentrate on the following parts: The research on the necessary of building the migrant workers medical security system; The research on the model and system innovation of the migrant workers medical security system; The research on the responsibility of the government in building the migrant workers medical security system; The research on the plight and solutions in building the migrant workers medical security system.The author first pointed out clearly that the inter-governmental coordination mechanisms are missed in the building of the medical security system of migrant workers on the basis of summarizing previous studies of medical protection of migrant workers. Most of the migrant workers who contributed greatly to the China's economy development were excluded from the current health care system in our country, and they could not enjoy the minimum basic public services. The health care system is not uniform, resulting that it is hard to converge the medical security system of migrant workers in different places, and the migrant workers preferred to leave from it. At the same time the narrow channels of financing during the construction of the medical security system restricted the development of it. Secondly, the author analyzes the major contradictions and obstacles in the building of an effective coordination mechanism between the Government in the construction of the medical security system of migrant workers. The author believes that the main contradiction facing are as follows: Firstly, there is a game between the interests of local governments in the course of implementation of public policy. And in the game self-protection emerged when the economy activity is not conducive to the interests of local government, which bring to an obstacle to the building of the effective intergovernmental co-ordination mechanism. Secondly, there is an paradox between policy coherence and flexibility in policy implementation. The establishment of migrant workers medical insurance system is a national public policy. Local governments take non-cooperative action with the Central Government by taking alternative means of implementation in the Central Policy in order to protect their own interests. Thirdly, there is an paradox between the bureaucratic which has non-personification and alternative administrative means. There are four obstacles: Emphasis on the pursuit of self- interest because of the lack of restraint; The lack of reasonable and effective laws and regulations in coordinating interests; Unbalanced regional economic development; The decline in the authority of the central policy.Finally, the author explored the path of the intergovernmental coordination mechanisms in the construction of the migrant workers medical security system. The author points out general principles in building a coordination mechanism between the Government in the establishment of migrant workers medical insurance system: The principle of the rule of law; The principle of equalization of basic public services; The principle of tripartite cooperation among the government, enterprises and migrant workers. The author explores the path of the construction of the Government coordination mechanism in migrant workers health insurance system from three perspectives: The establishment of legal coordination mechanisms; The establishment of financial co-ordination mechanism; The establishment of administrative coordination mechanisms. In the legal coordination mechanisms the author believes that there are three things should be noted: The central Government should introduce "The Law on the Protection of migrant workers health care," which include the overall principles and the reasonable implementation rules of the migrant workers medical security system. The implementation standards in the local government legislation can not be less than the standard formulated by the central standards. The norms of the system should be chosen when the local system conflicted; Doing a good job in publicity work on "The Law on the Protection of migrant workers health care"; we should expand the migrant workers'legal means of their health care demand. On the establishment of the financial coordination mechanisms, the author believed that the central government should strengthen on the capital input in the migrant workers health system; National migrant workers health financial transfer payment system in the migrant workers insurance should be established; The financial subsidies system of migrant workers health insurance should be established. On the establishment of the administrative Coordination mechanism, the author believed that we should establish a unified national health care organization of migrant workers; The central government should strengthen efforts on cross-regional coordination; Cross-health monitoring system should be established; The information base of migrant workers health system should be established; The urban-rural integration labor market system should be established.