The past and present life of the "New Farmers' Cooperative"

" ====? After searching the official website of the Central People's Government of the People's Republic of China, as well as the official website of the National Health Commission of the People's Republic of China, combining the contents of the New Rural Cooperative Medical Care in the Baidu Encyclopedia, the MBA Think Tank of the Baidu Encyclopedia, as well as the Law Library, etc., and after organizing and sorting it out by myself, I will transcribe it and record it in as simple and easy-to-understand words as possible in the hope that I can help friends in need.? ==== ? "

This article will be based on the "timeline" to sort out, try to tell the "past and present life" of the "new rural cooperative".

The "New Rural Cooperative Medical System" (NRMS) is a new type of rural cooperative medical system that was developed prior to the 1980s, in contrast to the traditional rural cooperative medical model.

In the early days, it was also known as "cooperative medicine". Cooperative medicine refers to a socialist medical system established by the members of the People's Commune on the basis of collective strength and voluntary mutual assistance, and it is a collective welfare program for the members of the commune.

The traditional rural cooperative medical insurance system has played an important role in ensuring that farmers have access to basic health services and alleviating poverty caused by illness and returning to poverty due to illness. It has provided a model for the problems prevailing in countries all over the world, especially in developing countries, and has not only been welcomed by farmers at home, but has also been well received at the international level.

At the 27th World Health Assembly in May 1974, third world countries generally expressed enthusiastic concern and great interest. The United Nations Women's and Children's Fund pointed out in the annual report of 1980-1981, China's "barefoot doctor" system in backward rural areas to provide primary care, for underdeveloped countries to improve the standard of health care provides a sample. The World Bank and the World Health Organization called China's rural "cooperative medicine" a "model for developing countries in addressing health financing".

In its nearly 50 years of development, "cooperative medical care" has gone through the budding stage in the 1940s, the initial stage in the 1950s, the development and heyday stage in the 1960s and 1970s, the disintegration stage in the 1980s, and the restoration and development stage since the 1990s.

The "cooperative medical system" consists of three parts: "cooperative medical care", "health stations" and "barefoot doctors". The cooperative medical system consists of three parts: "cooperative medical care", "health stations" and "barefoot doctors". The development of cooperative medicine has gone through the following stages:

As early as during the War of Resistance Against Japanese Aggression, the military and civilians in the liberated areas responded to Comrade Mao Zedong's call for "do-it-yourselfers to get enough food and plenty of it" by organizing various forms of cooperatives, including medical cooperatives (health cooperatives). At the beginning of the founding of the People's Republic of China, the northeastern provinces also actively advocated the use of the cooperative system and the public collection of funds to organize grass-roots health organizations, which was affirmed in an article published in the People's Daily on September 27, 1952, entitled "Three Years of China's People's Health Care". These medical cooperatives of a mutual ****ancial nature can be said to be the prototype of cooperative medicine, laying the foundation for the subsequent development of cooperative medicine.

At the time of the founding of the new China and the development of the national economy, the state focused its economic growth on urban industry and promoted industrial development through the scissors difference between urban and rural areas. As a result, the welfare of urban workers became the focus of the government's attention, while the protection of rural areas was not a priority. Under these circumstances, rural residents spontaneously formed a variety of mutual aid organizations to spread the risks they might encounter. The "cooperative medical insurance system" with the nature of mutual aid officially appeared in the rural areas of China in 1955 during the climax of rural cooperativeization. In Shanxi, Henan, Hebei, Hunan, Guizhou, Shandong, Shanghai and other places in the countryside appeared a number of agricultural cooperatives organized by the health station and medical station.

At that time, the Mishan Joint Health Station in Gaoping County, Shanxi Province, early implemented the "combination of medicine and society", adopting a combination of "health care fees" paid by members and "public welfare subsidies" paid by production cooperatives to set up a health care center. "In the winter of 1955, the Shanxi Provincial People's Committee (the provincial government) and the State Ministry of Health conducted a survey on this issue, summarizing and affirming the experience of the township as "the initial implementation of the collective health care system". It was regarded as "the initial implementation of the ideal of 'early prevention of disease, early treatment of disease, saving of work and money, convenience and reliability' of the peasants who had embarked on the collectivization of the countryside, and the establishment of a reliable socialist organizational basis for rural preventive health care". Afterwards, the experience of Mishan Township was popularized in some parts of the country, and a number of collective health care stations, cooperative medical stations or integrated medical stations based on collective economy, combining collectives and individuals, and mutual assistance were set up.

In 1956, the Model Statute of Higher Agricultural Production Cooperatives, adopted at the Third Session of the National People's Congress, stipulated that the cooperatives should be responsible for the medical treatment of members who were injured or fell ill in the course of their duties, and that they should be given a discretionary subsidy in terms of working days, thus for the first time assigning to the collectives the responsibility of interfering with the medical treatment of illnesses of members of the rural society.

In 1956, the Unity Farm in Wangdian Township, Zhengyang County, Henan Province, creatively put forward the term " socially run cooperative medical system".

In November 1959, the Ministry of Health held a national rural health work conference in Jishan County, Shanxi Province. After the meeting, the party group of the Ministry of Health reported to the Central Committee of China **** "on the national rural health work of Shanxi Jishan site meeting report" and the annex "on the health of the people's commune a few issues of the opinions", affirmed the people's commune members of the "collective health care medical system", and put forward specific proposals: "The medical care system for the members of the commune should be considered in the light of the level of development of local production, the degree of consciousness of the masses, the appropriate alleviation of the burden on the masses, the reasonable settlement of the wages and salaries of the medical personnel, and the gradual development of the health service. At present there are a very few economically rich people's communes which insist on the implementation of community-run, publicly funded medical care, which can continue on a trial basis, but should not be too busy to promote it. In other people's communes, the practice of "whoever seeks medical treatment pays for it" should not be changed in a hurry, but should be gradually transformed into a "collective health-care system" in accordance with the level of development of the commune's production and the degree of awareness of the masses. The main points are: 1) members pay a certain amount of money for health care every year; 2) they only pay for medicine or registration fees when they see a doctor; 3) they are also subsidized by a portion of the public welfare fund of the commune or brigade. With the development of production, the subsidized part of the public welfare fund will be gradually increased. Specific measures are to be developed by each region according to its own circumstances. The implementation of this system is more beneficial to the development of health prevention, to ensure that members can be treated in time if they are ill, and to consolidate the medical and health organizations of the commune." (Excerpted from the "Report on the Situation of the On-site Meeting on National Rural Health Work in Jishan, Shanxi")

On February 2, 1960, the Central Committee of the People's Republic of China (PRC) forwarded the report in Document No. 70 of China's Central Development (60), and requested that the report be implemented in all places. This gave a great impetus to the development of the cooperative medical system in rural areas.

In June 1965, Comrade Mao Zedong gave instructions to "put the focus of medical and health work in the countryside". On September 21 of the same year, the Central Committee of the People's Republic of China (PRC) approved the Report of the Party Committee of the Ministry of Health (MOH) on Putting the Focus of Health Work in Rural Areas as Document No. (65) 586, emphasizing the strengthening of rural grassroots health care and greatly facilitating the development of rural cooperative medical care.

After the People's Daily on December 2, 1968 introduced the experience of the Leyuan Commune in Changyang County, Hubei Province, in organizing cooperative medical care (which Mao Zedong notified himself of and praised as "cooperative medical care is good"), the construction of cooperative medical care in the rural areas around the world has set off a climax. Many peasants became "barefoot doctors" and Chinese medicine was vigorously promoted. In the vast majority of rural areas, counties, communes and production brigades set up medical and health institutions, forming a three-tier preventive health care network. At this time, the operation of the commune health centers mainly depended on the financial support of the community, while the brigade health offices relied on the collective economy to maintain the health office houses and equipment invested by the brigade, and the working capital and personnel funds were mainly allocated by the production brigade. Specific practices are as follows: rural production cooperatives and the rural masses*** co-finance the establishment of health-care stations. Each farmer pays a small annual fee for health care, and only pays for medicines, injections, changes of medicines and visits to the doctor. The funding of the health-care stations consists of three parts, namely, 15 to 20 per cent of the funds withdrawn from the public welfare funds of the agricultural cooperatives, the fees paid by the farmers for medical treatment and the profits from the operation of medicines. Health doctors are selected from barefoot doctors trained by the health department, and their remuneration is calculated according to a combination of work points and cash payments.

In villages where cooperative medicine is practiced, some of the fees for medical treatment in village health clinics are reduced or waived (known as "co-medicine"), some are reduced or waived for medicines (known as "co-medicine"), and some are reduced or waived for both types of fees (known as "co-medicine"). Combined Medical and Pharmaceutical Services"). In places with better economic conditions, some medical fees could also be reduced or waived when visiting communes and townships. By 1975, 90% of the country's production brigades organized cooperative medicine .

After the end of the Cultural Revolution, "cooperative medical care" was written into the Constitution of the People's Republic of China, which was adopted by the Fifth Session of the National People's Congress on March 5, 1978, in which Chapter III, Article 50 reads: "Workers have the right to material assistance in old age, sickness or incapacity to work. The State gradually develops social insurance, social welfare, publicly-funded medical care and cooperative medical care to ensure that workers enjoy this right."

On December 15, 1979, the Ministry of Health, the Ministry of Agriculture, the Ministry of Finance, the State General Administration of Medicines and the National Federation of Supply and Marketing Cooperatives jointly issued a circular issuing the "Statutes of Rural Cooperative Medical Care (Draft for Trial Implementation)," which required all localities to refer to and implement them in the light of the actual situation of their own regions.

The cooperative medical system has worked actively through the establishment of different levels of medical and health care institutions, and has been recognized by the World Bank as contributing to the "significant improvement in China's health situation and a significant increase in life expectancy of the population," and has been hailed as a successful "health revolution. It has been hailed by the World Bank as a successful "health revolution". It constitutes the safety net of China's medical security with the public medical care for urban residents and the labor insurance medical care***.

In the early 1980s, when the household contract responsibility system was introduced in the countryside, the collective economy and the traditional community base began to disintegrate and eventually disappeared, which shook the economic basis for the existence of cooperative medicine. The collapse of the cooperatives made it impossible for them to provide a source of funding for the normal operation of the village health centers, which led to the collapse of the village public health institutions, which could not continue to support them, and the "cooperative medical care" lost its main economic source. "As the barefoot doctors were unable to earn work credits in exchange for their medical activities and thus obtain food and other means of subsistence, they lost all incentive to go out and practise medicine, and many of the health clinics in the countryside were subcontracted to individuals, effectively turning them into private clinics. At the same time, the widespread application of market rules has led many people to believe that market rules should also be introduced into the medical field, with individuals paying for their own medical needs. In addition, coupled with the fact that there were also problems of mismanagement and ineffective supervision in the operation of cooperative medicine, it led to the large-scale disintegration of cooperative medicine, which was on the verge of collapse.

In 1985, only 5% of the country's administrative villages practiced cooperative medicine, and by 1989, even fewer, only 4.8%, continued to adhere to it. Self-financed medical care once again became the dominant medical system in rural areas. By the early 1990s, the only remaining cooperative medical systems in the country were in Shanghai and southern Jiangsu province.

The dismantling of the cooperative medical system had a great impact on the lives of farmers, as the costs of medical care were borne entirely by the individual, which increased the risks and health expenditures of farmers, and at the same time caused a significant increase in the number of farmers "impoverished due to illness" and "impoverished due to illness". At the same time, the number of farmers who are "impoverished due to illness" and "return to poverty due to illness" has greatly increased. According to surveys of rural areas in Yuhang, Zhejiang Province, Yantai, Shandong Province, Yichang, Hubei Province, and Xiangfan, the proportion of poor households impoverished due to illness accounted for 33.4%, 40%, 48.9%, and 64% of the total number of poor households in those areas, respectively. The problem is even more pronounced in the "old, young, border and poor" areas.

More and more poverty in rural areas is caused by disease, and the inability of farmers to afford medical care is no longer a problem of individual survival, but a risk to the survival of the group. In addition, with the economic and social development, the gap between urban and rural areas is increasing, in the city Du will be more and more mature security construction. The problem of rural security is no longer taken into account, which will cause social unrest and anxiety.

In fact, since 1979, the government has basically abdicated its responsibility for the health care of farmers, and the government's investment in rural health has been minimal. 1998, the government's total investment in health was 58.7 billion yuan, of which only 9.25 billion yuan was invested in the rural areas, which accounted for only 16% of the government's investment. 1991 to 2000, the cumulative total of government budgetary expenditure on rural health was only 69 billion yuan, which accounted for only 16% of the government's investment. Between 1991 and 2000, the government's budgeted expenditure on rural health totaled only 69 billion yuan, accounting for only 15.9% of the government's total budgeted expenditure on health.Between 1991 and 2000, the government's budgeted expenditure on health increased by 50,627.1 million yuan. However, health expenditure for rural areas increased by only 6.308 billion yuan, accounting for only 12.4 per cent. The consequence of this is that the rate of farmers who are sick but do not seek medical attention has risen from 23.7% in 1985 to 33.16% in 1998, and 63.69% of those who do not seek medical attention do so because of the economic difficulties of these farmers, which have risen by another 4.9 percentage points compared to 1993 (the rate was 58.8% in 1993 when the first national health service survey was conducted), so that farmers can no longer afford to see a doctor. The farmers can't afford to go to the hospital anymore.

In the face of the problems encountered in traditional cooperative medicine, the Ministry of Health organized theorists and practitioners to carry out a number of national studies. The main ones are: 1985-1993, by the World Bank loan, the Ministry of Health and the United States RAND Corporation cooperation in Sichuan Jianyang, Meishan County, "China's rural health insurance system series of studies"; 1987 Anhui Medical University and the Ministry of Health Department of Medical Affairs of the two provinces and one city jointly conducted a " In 1987, Anhui Medical University and the Ministry of Health Medical Department jointly conducted a series of studies on rural cooperative medical care system; in 1988, the Ministry of Health Policy and Management Research Expert Committee conducted a study on China's rural health care system.

In the early 1990s, China entered the stage of establishing a socialist market economy, and the question of "how to establish a rural medical security system in the new era" was unavoidably in front of us.

In 1993, the central government issued the Decision on Several Issues Concerning the Establishment of a Socialist Market Economic System, which stated that the rural cooperative medical system should be "developed and improved". The Policy Research Office of the State Council and the Ministry of Health conducted an extensive survey and research throughout the country, and put forward a research report on "Accelerating the Reform and Construction of the Rural Cooperative Medical Care System". After that, the Ministry of Health and the World Health Organization cooperated to carry out cooperative medical care pilot projects in 14 counties in 7 provinces. The Department of Medical Affairs of the Ministry of Health at that time made Kaifeng County and Linzhou City in Henan Province as the key areas to carry out the pilot work of cooperative medical care, and summarized certain experiences.

In July 1996, the Ministry of Health held a national conference on the exchange of experience in rural cooperative medicine in Henan Province. The meeting analyzed the emergence, development and role of cooperative medicine, clarified the objectives and principles of developing and improving cooperative medicine, and put forward specific measures to develop and improve cooperative medicine, laying the foundation for the development of cooperative medicine in the new period. After the conference, 19 provinces, municipalities and autonomous regions*** selected 183 counties (cities and districts) as provincial-level cooperative medical care pilots, and most prefectures and municipalities also selected a number of pilot counties, giving cooperative medical care a good momentum of development. According to statistics, by the end of 1996, the coverage rate of administrative villages with cooperative medical care had risen to 17.59%, an increase of 6.41 percentage points over the previous year.

At the end of 1996, the Central Committee and the State Council held a national health work conference in Beijing, and Comrade Jiang Zemin said in his speech: "Now many rural villages are developing cooperative medical care, which is y popular, and the people call it a "project of the people's heart" and a "benevolent policy". The people call it a "project of the people's heart" and a "benevolent policy". It seems that the key to strengthening rural health work is to develop and improve the rural cooperative medical system. This is the summary of long-term practical experience, in line with China's national conditions, in line with the wishes of farmers. It is necessary to further unify the understanding, strengthen the leadership, and actively and steadily do a good job in this matter." Comrade Li Peng in his speech also affirmed the historical role and practical significance of cooperative medical care, and asked the party committees and governments at all levels to unify the understanding, strengthen the leadership, actively and steadily to do a good job of cooperative medical care.

In January 1997, the "Decision of the Central Government and the State Council on Health Care Reform and Development" [Zhongfa (1997) No. 3], a special article was devoted to "cooperative medical care", which reads: "Actively and steadily develop and improve the cooperative medical care system in rural areas. Cooperative medical care plays an important role in ensuring that farmers have access to basic health services, implementing preventive health-care tasks, and preventing poverty due to illness. Cooperative medical care should be organized and led by the government, and should adhere to the principles of public assistance and voluntary participation. Funding should be based on individual input, collective support and appropriate government support. Through publicity and education, it is necessary to raise farmers' awareness of self-care and mutual assistance and to mobilize them to participate actively. Cooperation methods, financing standards, and reimbursement rates should be determined according to local conditions, and the level of health care should be gradually raised. The preventive health care reimbursement system should continue to be practiced as a form of cooperation. The scientific management and democratic supervision of cooperative medical care should be strengthened so that farmers can truly benefit. We are striving to establish various forms of cooperative medical systems in most rural areas by the year 2000, and to gradually increase the degree of socialization; where there are conditions, we can gradually make the transition to social medical insurance."

In May 1997, the State Council approved the "Opinions on the Development and Improvement of Rural Cooperative Medical Care" of the Ministry of Health, the State Planning Commission, the Ministry of Finance, the Ministry of Agriculture, and the Ministry of Civil Affairs. The Opinions affirmed that the "rural cooperative medical system" is a medical insurance system for farmers that suits China's national conditions, and determined that the basic principles of organizing cooperative medical care are public assistance, voluntariness, and adaptability to local conditions, and pointed out that in the process of implementing the cooperative medical care, attention should be paid to scientific management and democratic supervision, so as to enable farmers to truly benefit from the cooperative medical care, and required that all localities should strengthen their leadership and actively and steadily promote the development of the cooperative medical care system. It requires local governments to strengthen leadership and actively and steadily promote the healthy development of rural cooperative medical care.

With the continuous development of China's social and economic development, more and more people are beginning to realize that the "Three Rural Issues" is a fundamental issue related to the overall situation of the party and the country. Without solving the problem of farmers' medical insurance, it is impossible to realize the goal of building a moderately prosperous society in an all-round way, and it is impossible to talk about the complete establishment of a modernized society. A lot of theoretical research and practical experience has also shown that the establishment of a "new cooperative medical system" in rural areas is imperative.

In October 2002, China Development [2002] No. 13, "China *** Central Committee, the State Council on the further strengthening of rural health work decision" clearly pointed out that: to "gradually establish a new type of rural cooperative medical system, mainly to the coordination of major diseases," "by 2010 By 2010, the new rural cooperative medical care system should basically cover rural residents". "From 2003 onwards, the central financial administration will arrange cooperative medical care subsidies for farmers participating in the new type of cooperative medical care in the central and western regions, except for urban areas, at the rate of 10 yuan per capita per year, and local financial subsidies for farmers participating in the new type of cooperative medical care will be no less than 10 yuan per capita per year." "Farmers' fulfillment of the obligation to pay contributions for the purpose of participating in cooperative medical care and fending off the risk of disease cannot be regarded as an increase in the burden on farmers."

In January 2003, the General Office of the State Council forwarded the Ministry of Health and other departments "on the establishment of a new type of rural cooperative medical system of opinions on the notice" State Office of the State Council [2003] No. 3: "on the establishment of a new type of rural cooperative medical system of opinions," which requires that: from 2003 onwards, the provinces, autonomous regions and municipalities directly under the Central Government to choose at least 2-3 counties (municipalities) The pilot program should be implemented in each province, autonomous region and municipality directly under the central government, and gradually rolled out after experience has been gained. By 2010, to realize the establishment of a basic coverage of rural residents in the country "new rural cooperative medical system" goal, reduce the economic burden of farmers due to disease, improve the health of farmers.

In the same year, the Agricultural Law of the People's Republic of China (Revised) was considered and adopted at the 31st meeting of the Ninth National People's Congress, and was formally put into effect on March 1, 2003 . The newly amended Agricultural Law stipulates: "The State encourages and supports farmers in consolidating and developing rural cooperative medical care and other forms of medical protection, and in improving the level of health in rural areas." Thus, China's development and improvement of rural cooperative medical system has a legal guarantee.

In January 2004, the General Office of the State Council forwarded to the Ministry of Health and other departments "on further improving the pilot work of the new rural cooperative medical care guidance notice" State Office of the State Council [2004] No. 3: "on further improving the pilot work of the new rural cooperative medical care guidance," the "opinions" proposed: "rationally set up the integrated fund and family account ", "Each pilot county (city) shall, under the principle of adhering to the principle of coordinating major illnesses, determine the subsidy mode of the new rural cooperative medical care according to the actual situation, and encourage the grassroots to actively innovate. They should actively explore ways of subsidizing mainly large medical expenses, taking into account the subsidies for small expenses, and establish a family account while establishing a fund for the coordination of large illnesses. A part of the individual's contribution can be used to establish a family account, which can be used by the individual to pay for outpatient medical expenses; the rest of the individual's contribution and financial subsidies at all levels can be used to establish a comprehensive fund for major illnesses, which can be used to reimburse large-value or inpatient medical expenses of farmers participating in the new rural cooperative medical care. The proportion of individual contributions transferred to the family account shall be reasonably determined by each region."

Beginning in 2003, as of September 30, 2005, the "New Rural Cooperative Medical Scheme" was launched nationwide. In terms of financing, as of September 30, 2005, the total financing for the new rural cooperative medical care in 2005 amounted to 6.498 billion yuan, of which 2.735 billion yuan had been paid by individuals (with the Civil Affairs Medical Aid Fund contributing 331 million yuan for the benefit of those in need of assistance), 3.524 billion yuan had been paid in financial subsidies from the various levels of government, and 239 million yuan had been paid from other sources. In terms of compensation, in the first three quarters of 2005, total expenditures from the national fund totaled a cumulative 3.816 billion yuan. A total of 82,662,200 people were compensated, of whom 4,525,200 were hospitalized, 72,828,300 were compensated on an outpatient basis, and 5,308,500 were given medical checkups. The rates of consultation and hospitalization for participating farmers have increased markedly, the financial burden of medical treatment has been reduced, and the problem of farmers becoming poor and returning to poverty because of illness has been alleviated. The new rural cooperative medical system has been welcomed by the farmers.

In August 2005, Premier Wen Jiabao presided over a State Council executive meeting on August 10 to study the issue of accelerating the establishment of a new rural cooperative medical system, the meeting pointed out that: "We should summarize the pilot experience on the basis of increasing efforts to accelerate the pace of construction of a new rural cooperative medical system. In the next two years, the scope of the pilot program will be expanded, the relevant policies will be improved, and a new rural cooperative medical care system will be basically established in rural areas throughout the country by 2008. All localities should start from the actual situation and adapt to the local conditions, without doing anything across the board or imposing uniformity. Places in the eastern part of the country that have the conditions to do so can make faster progress." At the same time, it was requested that "the central and local financial support should be further increased, the pilot counties (cities and districts) should be expanded from the current 21% of the country to about 40% in 2006, and the subsidy standard of the central government for the farmers participating in the cooperative medical care should be increased by 10 yuan on top of the original 10 yuan per person per year, while the municipal districts of the central and western regions with the majority of the population in agriculture and the At the same time, municipal districts in the central and western regions with predominantly agricultural populations and some of the difficult counties (cities) in the eastern regions participating in the pilot program will be included in the scope of the central financial subsidies. Local finances should increase their subsidies accordingly. The contribution standard for farmers will not be raised, and the burden on farmers will not be increased. It is necessary to further improve the management and operation mechanism of the new rural cooperative medical care, explore the establishment of a stable financing mechanism, and effectively strengthen the supervision of the cooperative medical care fund."

In January 2006, the seven departments jointly issued the Notice on Accelerating the Pilot Work of New Rural Cooperative Medical Care, Wei Nongwei Fa [2006] No. 13, which reads, "In accordance with the spirit of the 101st executive meeting of the State Council and the 2005 National Conference on the Pilot Work of the New Rural Cooperative Medical Care, starting from 2006, the relevant policies will be adjusted. intensify efforts, accelerate progress, and actively promote the pilot work of new rural cooperative medical care." The Notice specifies the objectives and requirements for expanding the pilot program: "All provinces (autonomous regions and municipalities) should, on the basis of carefully summarizing the pilot experience, increase their efforts, improve the relevant policies, and expand the pilot program of the new type of rural cooperative medical care. In 2008, the system will be basically implemented nationwide; in 2010, the goal of basic coverage of rural residents by the new rural cooperative medical care system will be realized. Eastern regions may accelerate the pace of advancement on the basis of standardized management, and regions with the conditions may explore various forms of rural medical protection." Starting in 2006, the central government will raise the annual subsidy for farmers participating in the new rural cooperative medical care system in the central and western regions, except for urban areas, from 10 yuan to 20 yuan per person, with a corresponding increase of 10 yuan for local governments. Provinces (autonomous regions and municipalities) with genuine financial difficulties may increase the subsidy by 5 yuan in 2006 and 2007 respectively, to be put in place within two years. Local financial increase in cooperative medical care subsidies, should be mainly borne by the provincial financial, in principle, not the province, city, county proportional average share, can not increase the financial burden of the difficult counties. Individual farmers' contribution standards will not be raised for the time being. Meanwhile, municipal districts in the central and western regions where the proportion of the agricultural population to the total population is higher than 70%, and the pilot counties (cities and districts) in the six provinces of Liaoning, Jiangsu, Zhejiang, Fujian, Shandong and Guangdong will be included in the scope of the central financial subsidies. The central financial Liaoning, Jiangsu, Zhejiang, Fujian, Shandong and Guangdong Province in accordance with the central and western regions of a certain percentage of the subsidy standard arrangement of subsidies. Financial departments at all levels should conscientiously implement the new rural cooperative medical care subsidies, in the beginning of the budget in full arrangements, and timely allocation in place, for the smooth implementation of the new rural cooperative medical care to provide the necessary financial security."

By the end of 2006, the number of counties (cities and districts) carrying out the new rural cooperative medical care pilot program nationwide had reached 1,451, nearly double the number of pilot counties (cities and districts) in 2005. There were 410 million participating farmers, accounting for 46 percent of the country's agricultural population. With the standardization of the "reimbursement drug list", the simplification of the "referral procedures", the reform of township health hospitals and the correct publicity, the national participation rate has increased significantly.

In June 2009, the Ministry of Health's "Guiding Opinions on Carrying Out Instant Settlement Work at Provincial and District Municipal New Rural Cooperative Medical Care Points" (Wei Nongwei Fa [2009] No. 62), put forward: "Carrying out the work of instant settlement work at the provincial and district municipal (hereinafter referred to as provincial and municipal) new rural cooperative medical care (hereinafter referred to as New Rural Cooperative Medical Care) fixed-point medical institutions . instant settlement work." By the end of 2009, all provinces (autonomous regions and municipalities) shall formulate implementation measures for instant settlement at the New Rural Cooperative Medical Care (hereinafter referred to as "NRCM") designated medical institutions at the provincial and municipal levels. From 2010 onwards, 1-2 provincial and district and municipal designated medical institutions for the NAC will be selected respectively to carry out pilot work, actively explore and create conditions, and strive to realize the goal of instant settlement of NAC compensation expenses for most of the provincial and municipal designated medical institutions for hospitalization of participating farmers within three years on a provincial basis for the practical convenience of the majority of participating farmers. The work of instant settlement has been carried out in the provincial and municipal New Rural Cooperative designated medical institutions or in other areas with conditions, the work progress can be appropriately accelerated." At the same time put forward: "fixed-point medical structure to do a good job of timely settlement services," "the establishment of timely settlement and disbursement mechanism", "the establishment of simple, standardized referral system" and other requirements.

In July 2009, the five departments jointly issued the "Opinions on Consolidating and Developing the New Rural Cooperative Medical System," Wei Nongwei Fa [2009] No. 68, once again made clear: " Steady development of the New Rural Cooperative Medical System," "Gradually increase the level of funding, improve the funding mechanism ", "adjusting the New Rural Cooperative Compensation Program to benefit the rural population more", "standardizing the behavior of medical services and controlling unreasonable increases in medical costs", "adhering to a convenient way of accessing medical care and settling accounts, and doing a good job of enrolling the floating population in the New Rural Cooperative System. The government has also taken steps to "improve the management and operation system and enhance the service capacity of the management and operation system" and "strengthen the connection between the new rural cooperative system and other related systems". It is necessary to do a good job of connecting the New Farmers' Cooperative, the basic medical insurance for urban residents and the basic medical insurance system for urban workers in terms of relevant policies and handling services, not only to ensure that everyone can enjoy basic medical protection, but also to avoid duplication of enrollment and treatment, and to promote the smooth and coordinated development of the three systems. The consolidation and development of the new rural cooperative system concerns the immediate interests of hundreds of millions of farmers and is a major livelihood project. All departments should, according to their respective responsibilities, actively support, *** with Promote the consolidation and improvement of the new rural cooperative system, sustainable development.

At the end of 2010, a total of 3.3 billion people enjoyed the new rural cooperative reimbursement and compensation treatment, the establishment of the new rural cooperative system, effectively alleviating the economic burden of farmers' diseases, and promoting the use of medical services, the protection of farmers' health gradually appeared, and all walks of life in the community to give a high degree of attention to the new rural cooperative system.

By 2011, the new rural cooperative system had made new progress. The number of people covered has remained stable, and the level of financing has increased significantly. In 2011, the number of people participating in the NPIC nationwide was 832 million, with a participation rate of more than 96%, continuing to stabilize at a high level.