Investigation Of The Implementation Of The New Type Of Rural Cooperative Medical Care Problems

the new type of rural cooperative medical care system is a mutual assistant and aid system of peasants'medical care in our country which is organized,guided, supported by the government;financed by individuals, collectivities and the government;mainly focus on the comprehensive arrangement for serious disease while whose participation of it is themselves'call. There are three ways of financing for the new type of rural cooperative medical care, which are individuals'payment,collectivities' support and the government's subsidization.In 2003,General Office of the State Council issued a document named<Opinions about building new rural cooperative medical system>(2003 no.3),in which building new rural cooperative medical system has been brought up clearly and definitely, it also made specific definitions and rules of the objective and principles,financing standard,Funds management, medical service management,organizing implementation organizing management and implementation of the new type of rural cooperative medical care system as well as basis for departments of all levels to be in accordance with.Coming here, the new type of rural cooperative medical care system was officially established and began.March 17th 2009, the state council released the<the CPC Central Committee and State Council on Deepening the views of the medical and health system>.Things were announced in this document that to completing four main medicine and health systems and building a medical treatment and public health system covering all urban and rural residents.The new medical reform came up with that putting the new type of rural cooperative medical care in full operation,enhancing the government's subsidization level step by step,increasing peasants'payment appropriately and improving the ensuring capacity for the new type of rural cooperative medical care is a constituent part of medical security system.It aims increasing the participation rate of the new type of rural cooperative medical care up to over 90% during 2009～2011 and subsidization level up to￥120/year for each person. And what's more, the new type of rural cooperative medical care keeps to the following principles:voluntary participation,raising fund through multiple channels; revenue determines spending, moderate ensuring; experimental unit in advance,gradual popularization.Certain results had been acquired during the process of the new type of rural cooperative medical care:the highest participation rate in history, a prominent increase of the size of the fund and the beneficiaries,let alone the increasing subsidization level,etc.But some problems has also explored,in this article,we are going to concentrate on the following ones:1. Formulation issue of the essential medicines list of the new type of rural cooperative medical care:according to<Health ministry's opinion about adjusting and formulating new rural cooperative medical drug directory for reimbursement,not only the extend of the essential medicines list of the new type of rural cooperative medical care of each province should refer to the NLEM reasonably,but also the drug breed structure and quantity. During the implementation process,few provinces can meet the request because of the low economic development level.2.Medical expenses continues uptrend:although there is partial subsidization for hospitalization expenses and Outpatient expenses, participated peasants are still suffering from high medical expenses,which blocks the sustainable development of new type of rural cooperative medical care.Some social problems come along with it. In this article, we mainly discuss the following ones:participating peasants'the wrong conception idea and the idea that benefit comes first of hospitals and doctors result in induced conception which causes hospitalization costs uptrend of the participating peasants;it gives its contribution to burdening hospitalization costs of the participating peasants as the abuse of examination,medicines and chemical reagents and import fabric in primary medical establishment.3.Primary health care weakness:it is difficult for the primary health care to satisfy the diagnosis and treatment of complicated illnesses when there are construction shortage of the primary medical establishment and extreme imbalance of medical resources between city and countryside. The accessibility of rural essential drugs is bad because of the faultiness of the drug supply web for the countryside and terminal drug control.Aiming at the three issues above, the author analyses the influencing reasons and tries to give rational suggestions for solution by means of literature and demonstration consulting.