The Change Of Rural Health Care System In China: Historical Review And Theoretical Analysis

Rural health care system in China has undergone some major changes since 1949, and cooperative health care system is the most important content. Several years ago, the government began to spread the new type of rural cooperative medical care system to the whole rural area, more and more people now pay close attention to rural health care system. It is not only closely linked to rural residents' health, but also relative to rural economics development and society stabilization. Rural health care system in China made remarkable achievement in 1960s~1970s, which offered suitable health service with less payout and made peasants healthy. But rural cooperative medical care system had disintegrated slowly since 1980s. A large number of peasants could not pay for their diseases, and they became poorer. It is very meaningful to research the change of rural health care system in China now.In the article, we have reviewed the history of the process of institutional change and made a theoretical analysis. Firstly, we research the change of rural health care system from 1949 to 2006, divide the whole history into five periods, and analyze how the change affects the health of peasants and rural economic growth. Then we analyze the change rural health care system with theories of institutional change, we discuss the subject, causes, method and other factors of institutional change, and make some conclusions. Peasants and the government in China ever initiate and execute the new institutional arrangement in different periods. The emergency and tryout of new type of rural cooperative medical care system is an induced institutional change which initiated by the government. Institutional circumstances affect and limit the change of rural health care system. We also discuss the problem whether an institution is evolutionary or regulated by human.At last, we have made a simple analysis on the future of new type of rural cooperative medical care system which is established. Our standpoints are as follows: though it is different from the traditional cooperative medical care system, but the institutional circumstances have changed, so it is not suitable for the rural area; the possibility of new type of rural cooperative medical care system spread the entire rural area is small, because there are different development level in different rural areas; neither the social security system nor the commercial medical insurance cannot replace the cooperative medical system now, but they maybe make an important role in future.