【作者】 张增国；

【导师】 任宗哲；

【作者基本信息】 西北大学 ， 社会保障， 2008， 硕士

【摘要】 农村合作医疗是中国农村卫生工作的重点之一,其目的是为农民提供基本医疗服务,减轻农民看病的经济负担,解决日益严重的因病致贫、因病返贫问题,促进农村经济发展和社会稳定。农民对农村合作医疗制度赞成并缴费参合是该制度运行的第一步,也是整个制度建立与运行的基础和前提。因此,筹资是农村合作医疗运行的先决条件,也是其实现持续运行的首要关键点。然而筹资问题一直困扰着中国农村合作医疗的发展,筹资制度不合理是传统农村合作医疗衰落、瓦解的关键原因。同时,筹资制度不完善仍然困扰着新型农村合作医疗,严重阻碍它向农村社会医疗保障制度的发展。本论文尝试运用新制度经济学的基本理论来解释和分析中国农村合作医疗筹资机制的变化,以及通过制度变迁、制度创新理论作为主要分析框架,系统地对农村合作医疗筹资的环境、农村合作医疗的性质、筹资制度安排进行系统的研究。由于新型农村合作医疗是一项社会系统工程,是在特定的环境下萌生和发展起来的,研究新型农村合作医疗筹资的可持续性,就不能不对其所赖以存在的制度环境进行分析。新型农村合作医疗的筹资不仅要实现长期可持续运行,而且要通过筹资这一环节来推动新型农村合作医疗向农村社会医疗保障制度顺利过渡。论文在该理念的基础上提出了新型农村合作医疗筹资机制设计的理念和原则,进而从政府和农民两个筹资主体的视角对改进新型农村合作医疗筹资机制提出相应的对策。更多还原

【Abstract】 The Rural Cooperative Medical System (CMS) is one of the focal points of China’ s rural hygiene work, its purpose is to provide the basic medical treatment service for peasants, lighten peasant’s disease financial burden, prevent the problem of poverty caused by illness, promote development of rural economy and social stability. Peasants approve CMS and pay the fees, is the first step in the functioning of the system, and the whole system that set up and operated foundation and prerequisite too. Therefore, it is the precondition that CMS operates to raise funds, and is also the most important key point which it realizes moves continually. However, the financing question has been puzzling the development of CMS all the time, and the financing system unreasonable has been the essential reason which the tradition CMS declines, disintegrates;Meanwhile, the system remains imperfect plaguing the new rural cooperative medical care, and hinder it from ensuring the development of the system to the Health Care Security System seriously.This paper tried to use the elementary theory of the new institutional economics to explain and analyze the financing mechanisms changes, as well as through the system vicissitude, the institutional innovations theory takes the main analysis frame, and systematically studies the medical fund raising environment, the rural cooperatives medical service nature, the fund raising institutional arrangements. Because CMS is a social system engineering, and germinates and develops under the particular environment. Studying its sustainability, has to analyze to the system environment which depends on. In this paper, the author obtains the development trend of CMS is t the Health Care Security System initially by analyzing the system environment in the poverty-stricken areas, thus had determined a main key for, its financing not only achieve long-term sustainable operation, but also impel NCMS to transit smoothly to the Health Care Security System. Under the guidance of this goal, this paper presents a new type of the financing mechanisms and principles, then proposes the corresponding countermeasure to improve the financing mechanisms from the visual angle of two fund-raising subjects of government and peasant.更多还原