Study On The Operation Status Of New Rural Cooperative Medical System In Tonglin County Of Anhui Province

In2003, the State Council of China decided to establish a new rural cooperative medical system to make rural residents enjoy basic medical insurance and to solve the problems caused by illness in rural area. In order to get a comprehensive understanding of the new rural cooperative medical policy implementation, the author did a research on Tongling County which is the first one of the ten pilot counties in Anhui Province.And some important findings are got by investigating the rural residents and some administrative departments of the new rural cooperative medical system. In this thesis, both the advantages and disadvantages of the new rural cooperative medical system are mentioned. Based on the findings, some proposals are put forward for Tongling County People’s Government and the relevant administrative departments to improve the new rural cooperative medical system.In the thesis, the author uses many methods which includes literature review, empirical research, qualitative analysis and quantitative analysis. On the one hand, the author collects some files related to the new rural cooperative medical policy from2003to2011in Tongling County (compensation package, the condition of the rural residents participating in new rural cooperative medical, capital raising, outpatient expenses relief, compensation for hospital fees, etc.); on the other hand, the author uses questionnaires to get some advice and suggestions about the new rural cooperative medical policy by investigating the rural residents and some administrative departments of the new rural cooperative medical system. In the thesis, some important findings are got and some proposals are put forward through analyzing of the statistics. All the data are analyzed by using EXCEL.The study produced the following major findings. The first, a new type of rural cooperative medical care system and operation mechanism has been established. And the new system has achieved great success under the leadership of the government of Tongling County and active participation of the majority of rural residents and medical institutions. And an effective regulatory mechanism of the new type of rural cooperative medical care has been established which includes medical services, supply of medicines. The second, the operating mechanism of the new type of rural cooperative medical care in Tongling County develops very well. With the increase of financial investment and per capita funding besides the improvement of the compensation package, rural residents benefit a lot from the new type of rural cooperative medical care. So they actively join in the new system. And they think highly about the system. The third, the township hospitals still remain low development trend. Due to the poor condition of township hospitals and the lack of medical personnel, they can not meet the medical needs of ordinary people even though they have advantage on the reimbursement rate. In the first years of the implementation of the new cooperative medical care, township hospitals developed to some extent. As the transportation becomes more convenient, the rural residents want to get better medical service. They usually go to medical institutions above the county level, if the clinic in the village fails to treat their diseases. This makes the township hospitals become unpopular sandwich layer. In the survey, only30%of th the rural residents participating in new rural cooperative medical in sick selected township hospitals. The fourth, the rural residents’pocket costs are still high. When they are sick they are likely to go to the hospitals at county level or above. The high threshold fee and using medicine outside the "new rural cooperative medical reimbursement drug catalogue "together with using advanced equipment for checking result in the rising health care costs. The rural residents still need to pay a lot after the reimbursement. So the burden of medical care fee is still heavy for them. The fifth, the fund of the new type of rural cooperative medical care is raised in single way. The rural residents should pay the funds during certain time at certain place. It is inconvenient for them. If they fail to pay the fund on time the village cadres will come to their home to collect the fund. They want more flexible pay methods, such as deducting the fee from the reimbursement of medical fee and food compensation. In the survey,36%of the farmers choose the debit payment method, and this payment method is more convenient for migrant workers. The sixth, It is difficult for the rural residents and the medical personnel to accept the frequent changes in the compensation package. During the nine years implementation of the new cooperative medical care, the compensation policy differs every year. Although the new rural cooperative medical management agencies every year issue a lot of promotional materials and broadcast the policy on TV very few persons can understand it throughout. Over90percent of the medical staff in the designated medical institutions claim that the new rural cooperative policy changes too rapidly and51percent of the rural residents feel it difficult to follow the policy. Even5percent of the rural residents do not know the policy at all. The author put forward some proposals which are based on the research of the new rural cooperative medical care system in Tongling County. The first, the government should know its responsibility clearly. The second, a long-term stable fundraising mechanism should be established. And the government should keep the policy relatively stable and publicize the policy. The fourth, the government should speed up to make laws about the new cooperative medical care system. The fifth, the government should strengthen the capacity building of grass-roots health institutions. Considering the future of the new type of rural cooperative medical care in Tongling County, the author suggest the government should merge the new type of rural cooperative medical care with urban residents medical insurance after the author compare the similarities and differences of the two medical care systems.