Research On The Integration Of Urban And Rural Medical Insurance System In Zhengzhou

As the main part of social security system,medical insurance system is the significant safeguard mechanism of national health,and the stabilizer of the social development.The basic insurance system of our country is consisted by the medical insurance for urban workers,the medical insurance for urban residents and the new rural cooperative medical system.Now it's basically universal coverage.However,due to the restriction of the urban-rural dual social structure,the three medical insurance systems are running separately.On account of the imbalance of the economic development and with the characteristics of diversification and fragmentation,the basic medical insurance system reveals problems of the division of the urban and rural,the division of districts and management,which are not conducive to elaborate the equity of the medical insurance system,to promote the flow of human resources,and to the sustainable development of the medical insurance system.Meanwhile it would solidify the urban-rural dual structure.During the process of the urban-rural integration,the increasing population mobility and the changing occupational status,the integration of the urban and rural medical insurance system has been an inevitable demand of the economic and social development.In 2016,the State Council released the policy of the Integration of Urban and Rural Medical Insurance System,which instructed how to integrate the urban residents' medical insurance system and the NRCM clearly for the whole country.Afterwards,Zhengzhou Municipal Government also introduced relevant policy to implement the medical insurance system for the urban and rural residents from the beginning of the year 2017,which is managed by Zhengzhou Municipal Human Resources and Security Bureau.Zhengzhou is the provincial capital city of Henan and the core city of the Central Economic District,where the scale of mobile population is quite tremendous.With the process of urbanization,many rural residents are confronted with the convert situation of income,status and methods of medical care.Therefore,it is meaningful to research on the integration of urban and rural medical insurance system in Zhengzhou,which could contribute to achieve the equality of basic public services in both urban and rural areas,safeguard the health equality of urban and rural residents and promote the coordinated development of urban and rural areas in Zhengzhou.The research methods of this thesis conclude the comparative study,the case study and the interview method.This thesis firstly introduces the theories related to the integration of the urban and rural medical insurance system.Then this thesis summarized the historical evolution of the urban and rural medical insurance system of our country.By the example of Zhengzhou,this thesis illustrates the differences of the three systems at the aspects of coverage,compulsion,fund-raising mechanism,compensation system and the management system.The next sector of this thesis is about the experience of four typical and leading models of the integration of the urban and rural medical insurance system.Through the declaration of the four implementation paths,this thesis summarizes their common features and provides reference to other districts.After that,the current situation of the integration of urban and rural medical insurance system in Zhengzhou is stated in the policy background,the basic regulations and the other supporting policies.Also,the implement effects of the integration are stated in some aspects.Also,the will of the residents and the factors that may influence on the will are analyzed by the method of Logistic and conclusions are stated.In the final chapterthe thesis stated some issues existed including the imperfection of the medical-insurance management system,the needy to improve the capacity of the primary health services,the lack of cohesive mechanism between the two medical insurance systems and the insufficient policy publicity.Then some possible suggestions are put forward,which consist of consolidating the forces construction of the medical insurance management,improving the services of the primary hospitals,establishing the cohesive mechanism between the two systems and the dynamic funding mechanism of the medical insurance system,and proactively organizing the medical security bureau of Zhengzhou City.