Understanding The Regional Differences Of The De-commercialization Level In China's Urban And Rural Resident Medical Insurance Policies And Their Source

After the Reform and Opening-up in China,the government at the county level has become the key to develop Urban and Rural Resident Basic Medical Insurance System.But its de-commercialization level has revealed a significant difference in different areas.De-commercialization mainly refers to the irrelevance between the personal welfare level and their contribution of labor which means people can get welfare without paying fees and market dealings in order to describe the personal and public responsibility in social welfare system.Some local governments tend to provide a medical insurance policy of high de-commercialization level,such as the mode of universal free medical treatment in Shenmu County in Shaanxi Province,and some other local governments tend to provide a medical insurance policy of low de-commercialization level,such as Chuzhou City in which the reimbursement ratio of its medical insurance policy is less than 50%.Committed to explore the regional differences of de-commercialization level and their source of Urban and Rural Resident Basic Medical Insurance,this paper mainly adopts case comparative study approach,and has carried on a on-the-spot investigation and interviewed some related government officials in Pinghu City and Deqing County in Zhejiang Province.In addition,this paper selects 25 cities of different economic development level in China as a comparison,in order to analyze the relationship between economic development level and the de-commercialization level of different policies.On this basis,using policy analysis and case study,this paper mainly has the following two findingsFirst,the way to explain the regional differences of de-commercialization level of medical insurance policies through economic development level is actually insufficient.Specifically,the relationship between economic development level and de-commercialization level is obviously nonlinear.Which means the developed cities and underdeveloped cities are both likely to provide a medical insurance policy of high de-commercialization level.And cities at the similar economic development level are also likely to provide Urban and Rural Resident Basic Medical Insurance Policies which de-commercialization level is totally different.Second,under the external policy constraints,the regional differences of de-commercialization level are mainly caused by the local noneconomic factors,which include local fiscal capacity and its preference on financial income maximization,and the preference of policy entrepreneurs who internal or external the system and the relative strength of the direct stakeholders on local policy stage(mainly refers to the department of social security,the department of health and medical institutions and the general public).Specifically,when the fiscal capacity of the local government is stronger,and its tendency to maximizing financial benefits is weaker,and the preference of the policy entrepreneurs who have stronger innovation consciousness and professional ability internal or external the system is tending to improve the de-commercialization level,then the de-commercialization level of Urban and Rural Resident Basic Medical Insurance Policies will be relatively higher.At the same time,compared with the power of the department of social security,if the power of the department of health and medical institutions is weaker,and the participation power of the general public is stronger,it will also improve the de-commercialization level of Urban and Rural Resident Basic Medical Insurance Policies to a certain extent.Finally,the conclusions of this paper will help our relevant government departments to further understand and consider the arrangement of local medical insurance policies.At the same time,the conclusions will also provide material support for high level government in order to achieve the higher level integration of medical insurance policy,which can insure that they can fully consider the intrinsic demands and behavior logic of relevant stakeholders when new medical insurance policy is being designed.