Research Of Integrating Urban And Rural Basic Medical Insurance Management System

The Basic Medical Insurance System is the social system which was established under the government leading to prevent disease risk.China's Medical Insurance System was established in the 1950 s,after more than 60 years of ups and downs,and finally it constitutes a system with the Basic Medical Insurance System for Urban Workers,the Basic Medical Insurance System for Urban Residents,and New Rural Co-operative Medical System as the main part.It has achieved the goal of universal health insurance coverage during the 12 th Five-year Plan and it basically meets the medical care needs of public.But under the influence of the logical inertia and system dependence of urban and rural economic and social division,the Basic Medical Insurance management system in urban and rural areas of China has continued the "segmentation" feature of the planned Economy Period,it presents the characteristics of "fragmentation" and "re-fragmentation" of urban and rural segmentation,division segmentation and geographical segmentation,which seriously lags behind the development requirements of Urban-rural Integration.At the same time,the disadvantages caused by the "division" of the Basic Medical Insurance Management System in urban and rural areas are also obvious: shortage of legal system,the law difficult to depend on,weak leadership of a central government,the rule division,multiple management handlers,regarding the difference between management and agent,the asymmetry of responsibility and authority,the weak supervision and so on,all these are seriously restrict the fairness and efficiency of the Basic Medical Insurance System,which have become the key problem of the integration of Urban Rural Basic Medical Insurance System.With the rapid development of national economy and the continuous advancement of urban and rural integration,it has been equipped the political feasibility,economic feasibility and social feasibility.A few economically developed coastal cities first began to integrate exploration and they haveprovided valuable institutional resources to integrate the top-level design of Basic Medical Insurance Management System in urban and rural areas.Among them,the "progressive" integration of Dongguan,"integrated" integration of Shenmu,and the "three-doctor linkage" integration of Sanming are the most typical and instructive.On the basis of in-depth analysis of the integration feasibility,system design and management system of these three coordinating areas,this paper puts out that the common experience to integrate the basic medical insurance management system include the aim to“promote fairness and efficiency”,the guarantee of the integration of "determination reform and full authorization",the integration core of "unified administration and independent management".Finally,through the full demonstration of the foregoing,this paper argues that from separation to integration is not only the necessary logic for the development of urban and rural relations,but also the inevitable logic of the evolution of Basic Medical Insurance Management System.Integrating the Basic Medical Insurance Management System is a complicated and systematic project,which must be carried out in a coordinated way and implemented in a holistic way.In the integration process,we should adhere to the principle of "adhering to the government's lead and introducing the market mechanism" and the principle of "systematic planning and overall advance".In order to build a scientific,rational and efficient modern management system to improve system fairness,improve management efficiency and achieve sustainable development,we should strengthen the decision-making of legislative organs and the unification of administrative organs,make the agency independent and the supervision authority.