Study Of Management Issues Of The New Rural Cooperative Medical Service In Chongqing

The rural health reform has achieved great achievements since the New Rural Cooperative Medical Service (NRCMS) was in operation in the city of Chongqing, 2003. The attendance rate and hospitalization rate to the health institutes of township have increased significantly. The medical and health services to the farmers'participation have been guaranteed greatly. The financial burden of medical treatment has been relieved, and the problem that the farmers are reduced to poverty or restored to poverty because of diseases has been alleviated. However, the socio-economic development is not in balance and the construction and operation of the NRCMS's agencies are inconsistent in different areas of Chongqing. The above reasons both directly affect the enthusiasm of local farmers to participate in the NRCMS. The average participation rate coming from each experimental unit in Chongqing was 85.25% until November 2008; it was far below the national average level at the same time (90.50%).It is just the new era when Chongqing has the reform of Plan Urban and Rural Development as a Whole, plan for Urban and Rural Development and stand up against the impact of global economic crisis. There are so many problems that should be solved at the moment. How far away is the management system of the NRCMS which will be able to meet our city's reform requirement about the medical and health integration? To the NRCMS's agencies, how should the NRCMS's agencies scientifically adjust and carry out the policy of the NRCMS to fit with the local conditions? How to guide the peasant's enthusiasm about the NRCMS and boost their confidence in it? What kind of methods and proposals can facilitate the NRCMS's management system to develop harmoniously and stably for a long term?Our research began from the status of the NRCMS's management issues in Chongqing. This dissertation is to begin with our research into the present status of the NRCMS's management system in Chongqing. The management of the NRCMS's agencies was randomly selected to have the interviews. The NRCMS's agencies selected were mainly from ten districts(Ba-nan-District,Wan-sheng-District,Yong-chuan-District,Jiang-jin-District,He-chuan-District,Zhong-County,Liang-ping-County,Feng-du-County, Kai-County, Peng-shui-County)of the three administrative districts including the urban districts, the suburban districts, the remote northeast and southeast parts of the Chongqing. At the same time, A questionnaire was distributed to 500 participants from seven districts ( Jiang-bei- District,Ba-nan-District,Yong-chuan-District,Jiang-jin-District,Rong-chang-County,Liang-ping-County,Yun-yang-County ) where the participation rates were relatively high. Then a comprehensive analysis was made of the current problems existing in the NRCMS's management system, in the above ways.To meet the requirements for balancing Urban and Rural Development and in view of the present status of the new round of national health care reform; in the light of the problems that the management departments in charge of fund payment compensation are inconsistent, the form and intensity of the policy propaganda are very monotonous and insufficient, the moral risk and adverse selection are very prone to happen, the NRCMS's agencies are understaffed and has frequent personnel flow, this dissertation is to put forward some recommendations on how to successfully construct the NRCMS's management system.The recommendations are as follows: to improve the policy propaganda about the NRCMS and strengthen the legislative construction; to enhance the capacity the NRCMS's agencies; to tighten the fund management and strengthen the external monitoring; to establish and perfect the health information system; to amalgamate the management system of the NRCMS and consummate it's convergence with other medical insurance systems, to improve the co-ordination level of the NRCMS.