The current three forms of rural medical insurance

Currently China's rural medical insurance, broadly speaking, there are several forms of cooperative medical care, medical insurance, coordinated settlement of hospitalization fees and preventive health care contracts.

1. Cooperative medical care is the primary form of rural medical insurance suitable for China's national conditions.

The rural cooperative medical system is a rural health protection system with the nature of medical insurance supported by the government and financed by the farmers and rural economic organizations***. That is, farmers pay a certain amount of money each year for cooperative medicine, the collective and the government can also invest part of the *** with the formation of a special fund, farmers can be reimbursed a certain percentage of the medical expenses when they go to the doctor. At one time in the 1970s, it covered more than 90% of the countryside. Practice has proved that various forms of rural cooperative medical care is a good way for the peasant masses to resist the risk of disease through mutual ****support and ****together, and it is also the key to promoting the development of China's rural health undertakings.

Because the countryside has a tradition of mutual assistance, and cooperative medicine has been widely practiced in the countryside, coupled with the fact that the rural economy has developed considerably, which can provide the necessary financial support for the implementation of social security, cooperative medicine has a great According to the China Statistical Yearbook (1996). Feasibility, but rural cooperative medical care also has its limitations.

First of all, theoretically speaking, rural cooperative medical care is essentially only a kind of community security, not social security. It is only a welfare system within a certain community, with the residents of the community as the object of protection, and is closely related to the level of economic development of the community. It is not a system of protection enforced by the State and implemented uniformly throughout the country, nor does it have the financial support of the State, nor is it a form of national income distribution and redistribution. This form of security is unstable, it is a transitional form of security provision under certain socio-economic conditions, in the absence of a social security system, the community security is the most appropriate substitute, but it is strong substitution, and irreplaceable uniqueness is weak, so it will eventually be replaced by other security provision. And community security is likely to exacerbate social inequality and market fragmentation situation: community security is a security system provided to the members of the community, the greater the degree of difference between the community security of the various regions, the more detrimental to the realization of the horizontal equality of the security of the whole society; at the same time, the community security is likely to exacerbate the ? At the same time, community security is likely to exacerbate the urban-rural barrier. s segregation and division between rural communities, thus adversely affecting economic development.

Secondly, from the current implementation of the situation, in recent years, although there has been a degree of restoration and development of rural cooperative medical care, but the progress has been slow. 1996, the number of villages in the implementation of cooperative medical care accounted for only 17.6% of the country's total number of villages, the coverage of the rural population is only 10.1%, and in some areas, after only one or two years of operation, it is discontinued. The main reasons for this situation are:

One is that the leadership did not pay enough attention to it; in 1997, the nationwide promotion of cooperative medical care in rural areas set off a high tide, but after a period of time the enthusiasm gradually cooled down, and in some areas there was no person in charge of it, so it was not adhered to well.

The second problem is that the amount of funding is too small, and the collective and government subsidies are insufficient, thus failing to solve the problem of farmers being impoverished and returning to poverty because of illness.

Third, the supervision and management mechanism is not perfect. Some areas even leave all the medical fund in the township health center or the government at will, was squeezed and misappropriated the situation is serious, did not do the special funds for special purposes, special management, the farmers are not guaranteed reimbursement of medical expenses, thus refusing to pay, etc..

2. Medical insurance can play an important role in economic security.

Medical insurance has the dual nature of social insurance and commercial insurance, of which the former is as a basic guarantee, the latter is as a supplement. At present, the types of insurance already provided are enterprise medical insurance, family medical insurance, hospitalization insurance, outpatient insurance, etc. In order to promote the development of medical insurance, the state specially exempts from business tax the types of insurance such as farmers' medical insurance, farmers' hospitalization insurance, disease medical coordination hospitalization insurance, and residents' additional hospitalization insurance.

The conditions for the implementation of medical insurance are high, in which the social health insurance should be premised on the higher degree of industrialization and the higher income level of the agricultural population, i.e., high income level of large-scale insured people, but also need to be mandated by national or local laws, the statutory insurance companies have a high level of basic management and a good reputation, etc.; and the commercial health insurance excludes the poor health of the population to participate in the insurance. These conditions are not yet available in the vast majority of rural areas in China, and therefore are not suitable for universal promotion.

3. Coordination of medical expenses is an effective form of supplementation.

Some regions have implemented a system of medical insurance for farmers, where each farmer pays one dollar per year, and the township finance and village public welfare fund are each allocated one dollar for a combination of social coordination and family accounts, which can also effectively reduce the burden of medical care on farmers. However, the beneficiaries of this self-savings type of social security must first be the contributors. Farmers do not pay individually, the collective will not give the corresponding subsidies; farmers pay more, the collective will subsidize more, objectively formed the rich both rich and protected, the poor poorer the more no protection, this? The rich get richer and the poor get poorer. The result is clearly contrary to the purpose of social security to help the poor and prevent poverty.