The Analysis On The Key Issues Of The New-type Rural Cooperative Medical Care In SiChuan

In order to solve the occurrence of the farmers'problem that impoverished by hospitalization, and the illness back into poverty, the New Rural Co-operative Medical Care (Referred to as NRCMC) of NRCMC established, which is based on the "CPC Central Committee and State Council on the decision of further strengthening rural health work", promulgated by in October 2002. At present, the analyses of financing, compensation, health service and management models were separated. And the grasp of key issues of the NRCMC is also limited. Sichuan Province is a major agricultural province in the western region. It is useful to promoting the improvement of health level of the farmers in Sichuan Province by the analyses of the key issues of NRCMC. Combining the actual of Sichuan Province, this paper finds the key issue of the NRCMC through the Literature Review and Empirical Methods. And it finds a way to improve the NRCRC. This paper put forward the suggestion for the healthy development of NRCMC through the research on the key issues of the NRCMC. For this reason, this specific research ideas and the logical framework are as follows:Chapter One:Introduction. This section generalizes the background, development process as well as the researches significant of NRCMC; introduces the contents of this study and the method used; gives an overview of existing theories for the key issues of NRCMC through the literature review.Chapter Two:The status and key issues of Sichuan Province. Through the description of NRCMC status, this chapter leads to the key issues existing in NRCMC of Sichuan Province. The mainly issues of Sichuan Province's NRCMC are:a low level of funding in Sichuan Province; in the case of low funding levels, how to improve efficiency in the use of health resources through the organization and management of medical services; and, how to improve the efficiency of cooperative medical care funds through the payment system's reform, the management's innovation.Chapter Three:The analysis of NRCMC financing of Sichuan Province. This chapter is primarily through actuarial analysis to illustrate the funding level in Sichuan Province. That part illustrates the lack of funding at this stage in Sichuan Province from three aspects:First, selecting the highest level of funding in Wenjiang area in Chengdu city of Sichuan Province, making an empirical analysis according to the data released by the Government; Second, choosing the well-developed Chengdu, medium-developed Mianyang and relatively poor Neijiang, analyzing its funding level through field survey data and combined with the actuarial model; Finally, analyzing Sichuan Province's funding level through NRCMC working data announced by Sichuan Provincial Health Department.Chapter Four:The organization and management provided by the medical service in NRCMC. In the case of funds' shortfall of NRCMC, in order to improve NRCMC working efficiency, one of the best way is to let medical and health institutions provide farmers with more high-quality low-cost medical health services through providing organization and management for medical service. The chapter explores optimizing the allocation of resources, rational use of medical and health resources and increase the regulation of medical service process. First of all, analyzing the distribution status of health resources in urban and rural areas in Sichuan province, discussing the ways to solve the uneven distribution of health resources in which farmers can get more high-quality low-cost health services. Second, the two-way referral mechanism can promote the rational use of health resources. Analyzing the problems in two-way referral mechanism in Sichuan Province at the present, explores how to improve two-way referral mechanism, thereby enhancing NRCMC fund's efficiency from improving efficiency in the use of health resources. Finally, due to the waste of medical health resources in the process of service for it's professional, explores how to improve the utilization efficiency of cooperative medical care funds through strengthening the supervision of the process of health care services.Chapter Five:The reform and innovation of payment and management mode in NRCMC. Another effective solution to the problem of inadequate financing of NRCMC is to reform payment system and innovate management mode. Changing the current medical paying from post-payment into pre-payment, then the medical organizations can control the risk of medical costs from not cooperative medical insurance institutions, which prompts medical organizations to control medical costs actively and increases the efficient use of cooperative medical care funds On management model, introduced commercial insurance companies in NRCMC, improves the operational efficiency of NRCMC and financial efficiency through the use of the insurance concept, the professional management and actuarial techniques of insurance companies. This chapter gives suggestions to the payment system's reform of Sichuan Province NRCMC through comparing the mainly payment methods at home and abroad; and gives suggestions to management mode's innovation of Sichuan Province NRCMC from exploring the mode of commercial insurance's participating in NRCMC in China's other regionsThe main innovations of this article are the following:First, it grasps the key issues of the NRCMC comprehensively by analyzing the all aspects of the NRCMC.Second, it uses the actuarial model to analyze the problem of inadequate level of funding in the New-type rural cooperative medical financing by the data which the government announced.Third, this article tries to find the solution by improving the efficiency of using the Cooperative medical care funds and finds the models which the farmers can buy high-quality low-cost health services by the reasonable organizing and providing the medical and health resources, and Innovating the payment systems and the management models.Also, the survey data sample of the empirical part is limited, so it brings some effect on the analysis of fund-raising of NRCMC; on payment and management, due to lack of corresponding cases in Sichuan Province, this article can only do some exploration on theory to relevant experience at home and abroad, then the extension process may encounter more difficulties in practice. In the course of writing this article, because the author's level and energy are limited, with the best, but the article are still being some inevitable flaws.