Study On The Impact Of NRCMS On Medical Expenses For Medical Treatment

After the third plenary session of the eleventh central committee of the party in 1978,the household contract responsibility system replaced the original rural collective ownership.Under the reform of the market economy system,the original cooperative medical care system attached to the collective economy was no longer effective.With the change of the disease structure in the world,the problem of rural poverty is aggravated by the huge medical expenditure.In 2002,the Chinese government explored and established a new rural cooperative medical system based on the traditional rural cooperative medical system and the second rural cooperative medical system.The policy is based on the pooling of major diseases,with families as the unit,and individuals voluntarily participating in and receiving medical services and related subsidies.Since 2003 when the new rural cooperative medical care system(NRCMS)began to carry out pilot work in some counties and cities,the NRCMS has gradually become an important pillar in China's basic social security system with the continuous improvement of regional coverage rate and insurance participation rate.According to the blue book on society released by the Chinese academy of social sciences in 2006,"difficult and expensive access to medical services" has become the most prominent social problem in the minds of urban and rural residents in China.China is a large agricultural country with a large rural population base,and practical medical security is the focus of farmers' problems.Therefore,when the new rural cooperative medical care system is gradually accepted by farmers,it is worth exploring whether the new rural cooperative medical care system meets the needs of farmers for medical insurance and medical services.And in the party central committee is committed to comprehensive poverty alleviation,and realize the fair distribution of health resources of the present stage,the implementation of the new farmers and can solve the improving farmers' problem of " difficulty in seeking medical advice" under the premise of further easing farmers poverty due to illness and Chinese situation due to illness,to build a well-off society in an all-round way and improve the system of social medical insurance is of important theoretical and realistic significance.In this paper,first of all,the specific implementation of the NRCMS and policy changes are sorted out,and relevant important domestic and foreign literatures are systematically classified and analyzed.Then,the research perspective of NRCMS on farmers' willingness to seek medical treatment and medical expenditure is selected.This paper deeply analyzes and discusses the changes of coverage rate,participation rate and specific policy support brought by the policy changes during the decade.Secondly,based on the monopolistic status of medical institutions,the consumer utility function is used to distinguish patients' willingness to visit the doctor.On this basis,the upper and lower medical institutions will be introduced,and the effect of the changes in the insurance amount of the new rural cooperative medical insurance system on patients' actual medical expenditure will be analyzed through the three-stage game model and the reverse induction method under the dual track reimbursement mechanism.Compare the effect of NCMS on the fair distribution of medical resources and income distribution under different policy support and different social medical environment.According to a preliminary conclusion obtained from the theoretical model in this paper,using CHNS data and the CFPS data will be new farming policy period is divided into early and policy of stationary phase,using fixed effect model,quantile panel logit model,panel model and analysis method of PSM-DID new farming the use of a patient's medical resources and the impact of health spending.Moreover,different effects of the implementation of the NRCMS policy may be judged from the perspective of income heterogeneity and regional heterogeneity due to the large income gap in China and the differences in regional economic environment.This paper found that the NRCMS failed to promote patients to visit designated medical institutions in the early stage of the policy,but its actual effect on farmers' income redistribution was obvious.And the effect in the smooth period of policy is opposite to that in the earlier period.Although the NRCMS has solved the problem of farmers' difficulty in seeking medical treatment,the problem of high medical expenditure is still prominent.The expenditure effect of NCMS on the eastern and western regions is obvious,but the poverty reduction effect of NRCMS is prominent in the central region,which is the policy center.The implementation of the new rural cooperative medical system is conducive to the fair distribution of medical resources,but is not conducive to narrowing the income gap.The effect of the new rural cooperative medical system on the high score medical expenditure is more obvious.Therefore,the subsequent reform direction of the new rural cooperative medical insurance system should focus on the improvement of support,the improvement of reimbursement mechanism,and the further strengthening of moral hazard management to ensure the steady progress of the new rural cooperative medical insurance policy.