Case Study On Pilot Integration Of Urban And Rural Medical Security Management In Changfeng Anhui Province

The Neo-rural Cooperative Medical system (NCMS) was piloted in 2003, and has already been realized comprehensive coverage in 2008. It makes the most of Chinese population get over the status of having not any medical insurance. The problem of"poor access and high fee"for farmers get preliminary relief, and it is also helpful of promoting the development of rural social harmony and stability.In 1998, our country began to implement basic medical insurance system for urban employees and then the NCMS, it is only the non-employed residents in urban areas have not any medical insurance. In order to achieve the goal of"establishing the health care system which covers all urban and rural residents", The Central Committee of the CPC and State Council launched the basic health care system reform for urban residents in 2007.With the development of basic medical insurance system for urban employees, farmers and urban residents, it has basically achieved medical insurance universal coverage in the system. The NCMS is the medical mutual aid scheme for rural residents, which is organized, guided and supported by the government, and peasants can participate in voluntarily, funded by multiple parties including the individual, focused on compensating catastrophic diseases. And the basic medical insurance system for urban residents are mainly including the people such as primary and secondary students in the city, the elderly, unemployed people into health care and other areas, and also participate voluntarily, funded by multiple parties including the individual, the collective and the government. However, with the acceleration of urbanization process, the two medical care insurance systems appeared converged on the coverage, and gradually expanded. Such situation not only increased the management difficulties and fiscal spending in health and labor departments, but also increased the burden of people. And doctors'work also face many difficulties. In practical work, the NCMS and the urban resident medical insurance have much differences, such as designated medical institutions, medical forms are not unified, each having their own drug list, their own service system, the scope of its management, management methods, management procedures are all different, and it also induces much trouble to medical personnel. The doctors make some mistakes inevitably in their work, and the people don't understand it. Thus, the medical care systems designed unreasonable and also having some problems in the actual operation, make the people, medical personnel and the government workers unsatisfied, and the reform is imperative.Based on the above issues, government departments and experts in related fields have put forward some solutions. In December 2009, the pilot of local Medical Health System comprehensive reform was first put into implementation in Anhui, and in this health care reform the pilot of building"seamless integration"of urban and rural medical security systems was implemented.In order to test its feasibility, the government of Anhui province chose Changfeng, Shitai, Ningguo and Fanchang as the pilot areas. This paper uses case study method, makes Changfeng as a case study site, and tries to deeply understand of the situation of the two insurances"seamless integration", in order to provide a useful reference for the future.This paper uses case study as its main method, and in the pilot areas we choose interviews and questionnaires to invest. It is use the forms of questionnaires to the residents (including rural residents and urban residents) and medical personnel; and with the relative leaders of the health department (including the new rural cooperative medical management center) and social security departments we mainly use the forms of interviews.Through on-the-spot investigation, we can see that in order to ensure the work smooth and steady, before this merger the relative workers took a lot of careful preparation, the"seamless integration"in Changfeng goes well. At the same time, the government adhere to the"people-oriented"principles, get the people's recognition and support. The medical workers and government staff also positive this work, because it reduces their work stress and burdens. The most stakeholders support this work and it gets initial success, and will be a good example for other areas.