Function Research Of Local Government In The New Rural Cooperative Medical System

According to The Pure Theory of Public Expenditure of Paul A Samuelson, the definition of pure public products or services refers to one person's use does not reduce the amount available to others. Providing public goods and public services is the main function of the service-type government as well as the mission of improving government performance. The governmental supply efficiency and quality of the rural medical security system-a strategic public products-will affect the equalization of urban and rural security system and national treatment of rural residents. The new rural cooperative medical system(hereinafter abbreviated as NRC), which under the guidance of government to take the voluntary funding of farmers, being supported by the rural economic collectives and defrayed by a central government and local government grant, is a public health care system in rural district with interdependent character. Along with the social economic system reform, the traditional system which takes advantage of human cost instead of material cost to satisfy the cooperative medical supply loses the valid guarantee, for the collective economic disintegration and ideology transformation of people, and the transformation causes the further development of the rural public health security system innovation.This paper is divided into five parts, the basic framework and the internal logic is: The first part is the introduction. First of all, the paper points out that provide public products and public services is the main function of the service-type government, and the government should ensure the equal supply of urban and rural security system. Then the paper emphasizes the role of local government in rural health care system, and analyzes the three main features of the new rural cooperative medical system. Based on the advanced experiences and theoretical studies from both at home and abroad, the paper does the feasibility analysis of the new rural cooperative medical system.In the second part and the third part, in the empirical level, the paper cites the specific examples of the role of local government, makes the development situation of new rural cooperative medical system of Dandong as the research object, investigates circumstance of rural health resource as well as inquires performance of compliance duties and supervision of the new rural cooperative medical system by the government, points out that there are some operational problems in institutional arrangement. From the level of the specific facts, the paper observes and studies the real roles and functions of the local government.In the fourth part, the paper makes theoretical analysis on the problems of the new rural cooperative medical system, expatiates the properties of rural public products with the new rural districts'cooperative medical care character, analyses the problems of unbalanced supply and demand mechanism as well as dislocation of main body in medical supplies, indicates that, "voluntary participation" and "critical illness insurance" are the main reasons which trigger farmers'"adverse selection", and "moral hazard" exists in double-sided of health services in the new rural cooperative medical system.At last, the writer puts forwards the specific methods of local government's functions in the new rural cooperative medical system. Under the guidance of two ways of logic thinking-ideal and reality, theory and empirical logic, combining the analysis of specific issues, the paper points out that the top-down policy formulation mechanism leds to the urben tilted-policy which causes unbalanced supply mechanism of city and countryside, and the government should set up bottom-up expression mechanism to counterbalance the lack of the public option mechanism. The paper deems that the local governments should perform the functions from the three aspects of financial security, supervision mechanism, new rural public health security system. According to the theory of E. S. Savas, in the public service system, producer and deployer are two kinds of roles in addition to consumer supply of public product system and institution arrangement. The paper gives an idea that the local government can be a major producer of public health services, who sets up a three-tier public health service system in rural districts, and can be a provider in medicare systems, who makes a reform in administration system of rural health service institutions. As the centre of three-tier public health service system, the transformation of county hospital should develop the key specialties to promote the progress of the whole hospital. Finally, the paper proposes that, it is necessary to break up the dual social security structure of urban and rural areas as well as improve the level of equalization of the basic health medical services.