Impact Of The New Rural Cooperative Medical Scheme On Rural Resident’s Medical Burden

Objectives:This paper analyzed the difference of medical burden between the rural resident participating in the New Rural Cooperative Medical Scheme(NRCMS) and non-enrollee in China, and further explored the impact of the New Rural Cooperative Medical Scheme on the rural resident’s medical burden in order to provide suggestions on improve the NCRMS.Contents:This paper reviewed the theoretical and empirical research on the impact of domestic and international medical insurance system on resident’s medical burden; employed the contrastive analysis to study the difference between enrollees and non-enrollees form multiple dimension. This paper used the survey data from the China Health and Nutrition Survey and employed difference-in-difference method based on the fixed effect model to research the impact of NRCMS on the whole. Then, this paper investigated some differences across income groups and among different regions in the impact of NCRMS on medical burden. Based on the theoretical and empirical research, this paper put forward policy suggestions.Research Methods:By the method of literature research, collected theoretical and empirical paper and research reports, and so on. Data source is the survey data from the China Health and Nutrition Survey. The statistical analysis method to study the rural resident’s medical burden was utilized. Various econometric models to eliminate the unobservable factors were established. Results: This paper summarized and concluded the theoretical framework of this research by reviewing the theoretical and empirical research on the impact of medical insurance system. Descriptive statistics results show that NRCMS improvements had been made in terms of breadth and depth of service. The goal of NRCMS universal coverage had been achieving, and its participation rate had increased to more than90%. The actual reimbursement of NRCMS had been improved significantly, and hospital reimbursement had increased to44.68%in2011, which was29.24%in2006. From the statistical results, this paper did not find that the enrollee’s medical expenditure was alleviated significantly. But the NRCMS played an important role in the prevention of high health medical expenditure. Among different income groups, the NRCMS had no impact on the enrollee’s medical expenditure. However, the high health medical expenditure (20%and40%) of the enrollee which was low income group decreased by18.4%and10.8%, respectively. The low-income group has a greater risk on high medical expenditure than high income group. Moreover, the impact of NRCMS on actual reimbursement and out-of-pocket spending exist significant difference. The NRCMS had reduced out-of-pocket spending by22.9%in the east region, but had no impact in the middle region and west region. Conclusion:This paper found that the NRCMS improvements had been made in terms of breadth and depth of service. The goal of NRCMS universal coverage had been achieving, and the actual reimbursement of NRCMS had been improved significantly. In the despite of the improvement on coverage and reimbursement, this paper didn’t that the NRCMS had any impact on medical expenditure, however to some extent mitigated the risk on high medical expenditure. The NRCMS decreased the high health medical expenditure of the enrollee which was low income group, which relieved the unfairness on medical burden. But the low-income group has a greater risk on medical burden than high income group, and the illness-related poverty among the low income could not be ignored. Moreover, there had been significant differences in the impact of NRCMS among different regions, which caused the injustice of the system inevitably. Though various econometric models to eliminate the unobservable factors, this paper not only provide data support for evaluation about the impact of the NRCMS, but also reveal the problems in the NRCMS. Policy recommendations:Based on the empirical evident and problems in the NRCMS, this paper provider some suggestion. First, improve the NRCMS compensation levels and reduce the medical burden on patients participating in the NRCMS. Second, strengthen the NRCMS medical security effort on low income group and doing well the transition work with medical assistance system. Third, take a variety of ways to control rapid medical cost increases, for example, carry out the payment reform. Fourth, narrow the differences among different regions in the impact of the NRCMS on medical burden, central government spending on the NRCMS of middle and west region should increase.