【作者】 张春望；

【导师】 范广军；

【作者基本信息】 河南大学 ， 行政管理， 2008， 硕士

【摘要】 新型农村合作医疗制度是由政府组织、引导、支持,农民自愿加入、个人、集体和政府多方筹资、以大病统筹为主的农民医疗互助救济制度。从其社会功能来分析,应该是一种介于社会救助与社会保障之间的、具有保险性质的医疗互助的社会保障制度。建立新型农村合作医疗制度是切实解决三农问题、统筹城乡经济社会协调发展的重大举措,对于提高农民健康保障水平、减轻医疗负担、解决因病致贫、因病返贫具有重要作用,是构建和谐农村社会的“助推器”,是农民致富奔小康的“加速器”。政府作为新型农村合作医疗制度最大的供给者,是保持新农合制度平稳运行、可持续发展的核心和基础,其作用是不可替代的。这一点无论是从过去两次农村合作医疗经验教训还是从理论上都可以得到证明。目前虽然我国新型农村合作医疗取得了巨大的成绩,但政府责任在其中的履行并不完全尽如人意。因此,从理论上对政府职能进行重新定位,并探寻其实现途径就显得尤为迫切。论文试图通过社会调查、归纳总结等研究方法对这一问题进行研究。全文共分三个部分:第一部分:分析了我国原有农村合作医疗制度的历史变迁,阐述了原有农村合作医疗制度的意义,并通过对两次农村合作医疗制度的特点的归纳总结及不足之处的分析,指出政府是否履行责任是农村合作医疗成败的关键所在。第二部分:概述了我国新型农村合作医疗制度的重构和发展情况,分析了政府在新型农村合作医疗中承担责任的必然性与必要性,并通过社会调查、归纳与分析等研究方法分析指出了当前政府在新型农村合作医疗制度的责任履行上存在的逆向选择与逆向支付、农村医疗资源供应不足、筹资政策缺失、乡村医疗市场垄断、监督管理机制不健全、法律责任缺位等问题。第三部分:首先从理论上界定了政府在新型农村合作医疗制度中的职能定位,明确了政府责任。然后建议政府通过强化政策设计和创新、加大资金投入、改善农村医疗服务条件、建立科学筹资机制、取消定点医院,建立准入制度,破除乡村医疗市场垄断、完善农村合作医疗监督管理机制、加快相关立法、落实依法行政等途径,履行其在新型农村合作医疗制度中的职能。可以肯定,尽管目前新农合面临的问题很多,但随着政府职能的逐步履行,新型农村合作医疗制度一定会越来越合理、完善,最终广大农民也能和城镇居民一样享受到统一的医疗保障。更多还原

【Abstract】 New model system of rural cooperative medical services is to organized, led, held out by government, the peasant adds voluntarily, individual, collective and the government raise in many ways money, the peasant medical treatment giving first place to health insurance covering major cases of illness to help each other relieving system. The function comes to analyze from whose society, ought to be that one kind is situated between society succor and social security, has the social security system being sure that the character medical treatment helps each other.Building new model system of rural cooperative medical services is city and countryside economy society coordinated growth important measure conscientiously, resolving three agriculture problems, planning as a whole, return to improving a peasant cause healthy guarantee level, the disease lightening medical treatment burden , resolving a reason poor, being due to illness poor have the important effect , be the "auxiliary booster" structuring harmonious rural area society, be that the peasant sets out on a road to prosperity heading for the comparatively well-off "accelerator".The government is maximal supplier of new model system of rural cooperative medical services, is a core and basis closing stable operation of system, sustainable development keep the new agriculture, whose effect is irreplaceable. This can get a certificate theoretically all to some extent disregarding being that rural area cooperative medical care experience and lessons twice is still secondary from the past. Though our country new model rural area cooperative medical care has got gigantic achievement, but government responsibility, fulfilling among them are at present not completely entirely satisfactory. Therefore, comply with again allocation being in progress theoretically to government function, and find the way of fulfill the government function especially urgent right away. The thesis tries to study by the fact that research method such as social investigation, induction summary is in progress to this one problem. Full text divides into three parts together:Part I: The history having analyzed original system of rural cooperative medical services of our country changes, significance having set forth original system of rural cooperative medical services, and by the analysis summing up the summary and defects, the key location pointing out government if fulfilling responsibility is rural area cooperative medical care success or failure to two time of the system of rural cooperative medical services characteristic.Part II: Have summarized our country new model system of rural cooperative medical services weight structure and have developed condition, have analyzed government certainty and necessity undertaking responsibility in rural area cooperative medical care in new model, and have pointed out current government reverse choose and reverse payment having fulfilled existence in new model system of rural cooperative medical services responsibility by the fact that social investigation , being summed up as and analyzing and so on study method is analytical, rural area medical treatment resource The supply is short, financing policy hiatus, country medical treatment marketplace monopolize, supervision administration mechanism faulty, legal liability incomplete and so on problem.Part III: First secondary theoretically, the boundary has fixed the government fix position in function in new model system of rural cooperative medical services , has made government responsibility clear. And then suggest that the government throws into, improves rural area medical treatment condition of service by strengthening policy design and the fund being innovative, enlarging, build science financing mechanism, cancel the fixed point hospital, build certainty entering system, abolish country medical treatment marketplace function in the legislation managing mechanism, accelerating a relevance, the system of rural cooperative medical services ascertaining whose that wait for approach perform official duties according to law , fulfilling in the new model monopolizing , perfecting rural area cooperative medical care supervision. Can be affirmative, fulfill do not hesitate to question many facing the at present late-model system of rural cooperative medical services, but with government function successive steps, new model system of rural cooperative medical services is sure to more and more rational, improve and perfect, ultimate farmers also can enjoy same as the city and town dwell to unified medical security.更多还原