To finish reading
Xiangshan County determines the way to implement the new rural cooperative medical insurance system in 2008
--------------------------------------------------------------------------------
2007-11-2210:01:11Visits:94Information source:Municipal Health Bureau website
On Nov. 21, the county held a working meeting on the new type of rural cooperative medical care, announcing the adjustment policy for the new type of rural cooperative medical care for the year 2008.
The county's 2008 new rural cooperative medical care per capita integrated fund is 140 yuan. Among them, the financial subsidy of Ningbo City is 30 yuan, the financial subsidy of the county is 35 yuan, the financial subsidy of each township (street) is 30 yuan, and the individual contribution is 45 yuan. Rural five guarantees, low income, key beneficiaries and other difficult people to participate in the individual contribution part, still by the city, township (street) financial level at 50% each to give full subsidies.
With the new rural cooperative medical financing level, further expanding the scope of compensation for participating farmers, the establishment of outpatient cost compensation system, outpatient effective costs by 10% to be compensated for the maximum compensation of 150 yuan per person per year, while determining the 2008 outpatient cost compensation funds for the 8.6 million yuan, exceeding the portion of the outpatient costs compensated for the proportion of the fixed-point medical institutions. In addition, the hospitalization compensation method was adjusted accordingly, and it was determined that the starting line of hospitalization compensation for participants in township designated medical institutions, county designated medical institutions, and public medical institutions outside the county was 500 yuan, 800 yuan, and 1,600 yuan, respectively, and the compensation for hospitalization fees in designated medical institutions within the county was given in different proportions of 45%-75% for sectional compensation, and for those outside the county, the maximum compensation amount was 150 yuan per person per year. The compensation standard for hospitalization in fixed medical institutions and non-fixed medical institutions outside the county that meet the stipulated conditions shall be 50% and 40% of the portion to be compensated by fixed medical institutions within the county, respectively.
Rural cooperative medical care system
Rural cooperative medical care system (August 25, 1998)
(1) Establishment and development of the cooperative medical care system
Cooperative medical care is a system of mutual assistance and mutual aid in which China's rural society collects funds collectively and individually, and uses them to provide rural residents with low-cost medical care services. It is both a distinctive component of China's medical security system and an important element of China's rural social security system.
As early as during the War of Resistance against Japanese Aggression, there was a cooperative medical care system in the liberated areas that was financed by farmers. After the founding of New China, in some places, inspired by the agricultural mutual aid and cooperation movement after the land reform, the masses spontaneously raised funds to establish health care stations and medical stations of public welfare nature; in 1956, the National People's Congress adopted at the third session of the Model Statute of the Higher Agricultural Production Cooperative, which also stipulates that the cooperative is responsible for the medical treatment of members who are injured or sick on duty, and that they should be given discretionary work days as a This was the first time that collectives were given the responsibility of intervening in the medical care of rural community members. Subsequently, collective health-care and medical stations, cooperative medical stations, or integrated medical stations began to appear in many places, based on the collective economy and combining collective and individual assistance with mutual aid. It can be said that from the founding of the country to the end of the 1950s, rural cooperative medical care was in the stage of spontaneous construction in various places.
In November 1959, the Ministry of Health held a national rural health conference in Jishan County, Shanxi Province, which officially recognized the rural cooperative medical system. Since then, this system has been gradually expanding in the countryside, and in September 1965, the Central Committee of the People's Republic of China approved the Ministry of Health's Party Committee's "Report on Putting the Focus of Health Work on Rural Areas," emphasizing the strengthening of rural grassroots health care and greatly promoting the development of cooperative medical care in the countryside. By the end of 1965, cooperative medical systems had been implemented in some cities and counties in more than 10 provinces, autonomous regions, and municipalities directly under the central government, including Shanxi, Hubei, Jiangxi, Jiangsu, Fujian, Guangdong, and Xinjiang, and had been further popularized; even during the Cultural Revolution, cooperative medical care was so well received by the peasants that by 1976, 90% of the peasants in China had participated in cooperative medical care. Even in the midst of the "Cultural Revolution", because of the popularity of cooperative medicine among farmers, by 1976, 90% of the country's peasants had participated in cooperative medicine, thus basically solving the problem of difficult access to medical care for the majority of members of the rural community, and writing a glorious page in the development of rural medical care in the new China.
However, after the end of the 1970s, rural cooperative medical care was undermined and began to go into the doldrums.In December 1979, the Ministry of Health, the Ministry of Agriculture, the Ministry of Finance, the State General Administration of Medicine, and the National Federation of Supply and Marketing Cooperative Societies jointly issued the "Statute of Cooperative Medical Care in Rural Areas (Draft for Trial Implementation)," and all localities, again in accordance with the statute, reorganized their rural grass-roots health organizations and cooperative medical care systems, to The principle of voluntary participation by the masses of peasants was adhered to, with emphasis on voluntary participation and freedom of withdrawal, while the method of raising funds was improved. Since then, the rural cooperative medical service has been restored and developed in a few areas. However, with the implementation of the rural contract responsibility system in the 1980s, the decline in the accumulation of rural public ****, ineffective management, and the failure of health administrations at all levels to strengthen their guidance in a timely manner, most of the nation's rural areas were subject to the disintegration or closure of the original collective-economy-based cooperative medical system, and the vast majority of the village health clinics (cooperative health stations) became the private clinics of rural doctors. According to a survey of 45 counties in 10 provinces nationwide in 1985, only 9.6% of rural residents were still participating in cooperative medical care, while 81% paid for their own medical care. In 1986, the number of villages supporting cooperative medical care continued to drop to about 5%, and only a few areas such as Shanghai's suburb counties, Shandong's Zhaoyuan, Hubei's Wukou, Jiangsu's Wuxian, Wuxi, and Changshu continued to adhere to the cooperative medical care at that time.
Entering the late 1980s, the medical problems of members of the rural community again attracted the attention of the relevant government departments, and some localities, on the basis of summarizing the historical experience and in accordance with the development of the rural areas, also made improvements to the traditional cooperative medical system according to the local conditions, thus presenting different models. At present, rural cooperative medical care, as an aspect of rural social security, has been included in the development plan of the national health department and is being gradually restored and developed.
As can be seen from the above, the road taken by China's cooperative medical care is tortuous, and this kind of tortuous and other social security system is different, it is mainly because of the implementation of the rural contract responsibility system makes it lose the collective economic foundation, and at the same time there is no effective policy guidance caused by the consequences is the participation of cooperative medical care in the rural members of the community in 1976 accounted for 90% of the rural population has been reduced to about 5 percent in 1986, some localities are also participating in the cooperative medical care program. As a result, the proportion of rural members of society participating in cooperative medical care dropped sharply from 90 percent of the rural population in 1976 to about 5 percent in 1986, and the phenomenon of peasants finding it difficult to see a doctor, being unable to afford to see a doctor, or even being plunged into hardship and desperation because of illnesses has returned to some places. This process of the tortuous development of rural cooperative medical care should serve as a profound lesson for the entire socio-economic reform and development of China at this stage.
(2) Characteristics of cooperative medical care
Over the past decades, China's rural cooperative medical care system has had its successes and setbacks, and is still at a low ebb, but its characteristics are distinctive.
1. The cooperative medical care system covers rural residents. In China, urban residents generally have public medical care, labor insurance medical care or medical social insurance system to give health care and disease medical protection. But members of rural society, which accounts for more than 70 percent of the country's total population, lack the necessary medical protection. Cooperative medical care, as a medical security system gradually formed and developed by the peasantry in their long struggle against disease, has become the main support for solving the problems of medical care and health care for rural residents. Therefore, the cooperative medical care is created by the peasants and also serves the health of the peasants, and thus is mainly an important part of the rural social security system.
2. Cooperative medical care is based on the principle of voluntary participation of the masses. Cooperative medical care is a product of the cooperative movement, the essence is on the masses of mutual aid and mutual assistance, it from the beginning to emphasize the principle of the masses of voluntary, through the policy guidance, the implementation of the effect of the guidance as well as the masses of mutual influence to attract the masses to participate. For example, the state attaches importance to and supports cooperative medical care in its policies, treating cooperative medical care as a practical matter for rural residents; the public welfare and welfare nature of cooperative medical care itself has made farmers realize its benefits; the influence of the masses on each other promotes the active participation of members of the rural society; it is under the guidance of the three factors mentioned above that the cooperative medical care system is voluntarily participated in by the peasants, and has finally become a health care system. In the new historical period, cooperative medical care should still adhere to the principle of voluntary participation of the masses, but this does not exclude the policy guidance, government support and other measures to guide the voluntary participation of the masses to the masses to consciously participate in the cooperative medical care system so that the cooperative medical care system has become a mass medical security system in rural society.
3. Cooperative medical care is based on the collective economy. In the past few decades, the cooperative medical system and the rural community, the team collective accounting system, its funding mainly from the collective public welfare subsidies, members of the community to see the doctor only need to pay a small amount of money, and thus is a low-paying rural collective welfare undertakings. After the rural reform, cooperative medical care went into a downward spiral precisely because it lost the security of the collective economy. In the light of the realities of rural China, it is impossible for farmers to bear this responsibility alone, whether in affluent or poor areas. The protection and promotion of national health is the responsibility of the state and society. Although it is impossible for the State and all governments to repeat in the countryside the same path as the medical insurance system for urban residents, which is facing many difficulties, it is also impossible for them to leave the countryside unattended. Therefore, the State and society's responsibility for the health of rural residents will again be realized mainly through policy guidance and contributions from the rural collective economy, which has been the economic basis for cooperative medical care in the past and will continue to be the necessary foundation for cooperative medical care in rural areas in the future
.
4. Cooperative medical care is based on a full range of services. Although cooperative medical care is low-level and poorly equipped, it has a very rich content, as seen from the practice of the past few decades. In areas where cooperative medicine is practiced, it not only provides general outpatient and inpatient services for members of the rural community, but also undertakes tasks such as children's immunization, women's maternal health care, family planning, and monitoring of endemic diseases, and carries out all kinds of preventive work and dietary and drinking water sanitation, patriotic hygiene work, etc., in accordance with the policy of prevention and combining prevention and treatment. From this it can be seen that although cooperative medical care is established in villages and townships, and is the lowest level of crude medical care in China, it is "small in size, but complete in all respects", and plays a positive role in safeguarding the health of members of rural society in many ways.
In addition, rural cooperative medical care can provide medical services near or at home, which greatly facilitates the medical and health care needs of rural residents. The above characteristics of cooperative medical care determine its indispensability in the current stage of China's rural economic development and its irreplaceability in the rural social security system.
(3) Forms of Cooperative Medical Care
Before the 1980s, the model of cooperative medical care in rural areas in China was uniform and standardized because of the unified basis and uniform social policies of the collective accounting of all societies and teams throughout the country. After the rural reforms, however, the economic structure of the countryside underwent enormous changes, with extremely uneven levels of regional development, and uneven development in the same region and even in the same township or village, so that it was clearly unrealistic to restore and re-establish a unified rural cooperative medical system throughout the country. Under these conditions, although the State advocates the restoration and promotion of cooperative rural medical care, it is difficult to implement a uniform policy. Since the 1980s, therefore, it has been left to each region to explore the issue in the light of its own actual situation, resulting in a variety of cooperative rural medical care models. Specifically, the current rural cooperative medical forms are mainly the following:
1. Village-run village management type. That is, the cooperative medical station (point) to build their own, and managed by the village committee, its funding by the village collective economic organization (or village retention) and the village people *** with the implementation of the object is limited to the village residents, individuals enjoy the scope of the cooperative medical care and standards are set by the village, it is the past China's rural cooperative medical care in the form of the main. For example, in 1985, in the suburban counties of Shanghai, the implementation of cooperative medical care in 3037 villages, by the village village management accounted for 83.5%.
2. Village-run and township-controlled. In this model, the cooperative medical station (point) is still by the village committee to build, cooperative medical funding by the collective and individual **** with the fund-raising, but to enjoy the scope and standard by the village, township negotiation to develop the funds by the township health center or township cooperative medical management committee unified management, by village accounting, funding overruns by the villages to be self-financed.
3. Village joint-type. In this model, the cooperative medical station (point) by the township, village district construction, cooperative medical funding in addition to the village collective retention and personal contributions, the township regime also subsidizes part of the funds; funds by the township unified management, the township and the village divided into accounting, retention and reimbursement rate by the township, village consultation to determine the scope of the enjoyment of the standard by the township regime unified development. For example, in 1985, 13% of the rural cooperative medical care in the suburban counties of Shanghai belonged to this model.
4. Township-run and township-managed. In this mode, the cooperative medical station (point) is responsible for the preparation and construction by the township-level authority, and the funds for cooperative medical treatment are raised by the township, village and individual, and managed and accounted for by the township, and the scope and standard of enjoyment are formulated uniformly by the township.
5. Multi-party participation. In this model, in addition to the township and village levels of rural grass-roots power, there are other places to participate in the preparation of rural cooperative medical stations (points). For example, Shanghai Jinshan County, Hubei Jianli County, etc. in the local government and the support of the masses, the initial establishment of cooperative medical health insurance system. In Tingxin Township, a pilot township in Jinshan County, for example, the township has set up a "Cooperative Medical Care Health Insurance Management Committee," with the participation of the county health bureau, the county people's insurance branch company, and the township government in its management and coordination, and the participation of rural residents on a voluntary basis on a household basis, and of enterprises on a business basis on a township (including village) basis, with the payment of fees for registration by the township's "Health Management Committee. The rural residents participate voluntarily on a household basis, and enterprises in townships (including villages) on an enterprise basis; they pay fees and register, and the township "health management committee" issues health care cards, with which they are referred to the doctor or to the doctor at each level, and are reimbursed for their medical expenses according to a certain percentage. Statistics, from 1987 to 1989, the township **** raise health care insurance fund of 1.075 million yuan, during the same period, the township paid 1.435 million yuan, of which 413,000 yuan by the patient to pay, 1.022 million yuan paid by the health fund, and another expenditure of 450,000 yuan of management fees, revenue and expenditure is basically balanced.
6. The major disease co-ordination type. In this model, the cooperative medical care is only responsible for reaching the "big disease" standard of the rural community's medical problems, general diseases are not included in the scope of cooperative medical care. For example, Gaoyou City, Jiangsu Province, has implemented a cooperative medical care system for major illnesses, the basic content of which is: each person pays about 1.5 yuan per year for the co-ordination of funds, which are stored in the township's special account, and members of the rural community are reimbursed 20% of the medical expenses of 50-100 yuan at one time, and 30-40% of the expenses of 100-500 yuan at one time, and so on, with the maximum reimbursement of 70%, with more than 700,000 farmers in the city's 32 rural towns voluntarily taking part in this model. rural residents in the city's 32 rural townships have voluntarily enrolled in this cooperative medical care for major illnesses.
7. Mixed-guarantee type. In some places, a comprehensive rural grassroots security system has been set up, in which cooperative medical care is included. For example, Shiqu Township in Lucheng County, Shanxi Province, and Changyuan Village in Yuantan Township, Linxiang County, Hunan Province, have set up grass-roots social security systems in the townships and villages, in which cooperative medical care and old-age pension security are the basic contents, thus making them networked and comprehensive.
The above different models of rural cooperative medical system are in the process of exploration and development, the village-based or township-based good, single good or comprehensive protection is still debated. In some places, they are called medical social insurance or medical insurance, which is not yet true. Therefore, they are all part of the rural cooperative medical care system, which is consistent in terms of pooling funds from multiple sources, keeping expenditure within the limits of revenues, providing comprehensive services, and safeguarding the health of residents. According to a sample survey of more than 60,000 rural residents in 20 counties in 16 provinces conducted by the China Rural Health Care System Research Group in 1988, 30 percent of those participating in various kinds of cooperative medical care had already taken part in the program; according to the 1993 China Tertiary Industry Yearbook, by the end of 1992, 294,417 out of 651,031 village-level medical care facilities in rural China had been set up by the villages or by the masses collectively, accounting for 37 percent of all medical care facilities (37 percent of the total). Individual doctor-run medical points accounted for 44%, and points set up under township health centers and other forms accounted for 19%); a few areas are developing even faster; in the suburban counties of Shanghai, for example, after the process of establishing, slipping, and recovering cooperative medical care, 2,875 villages had implemented cooperative medical care in 1992, accounting for 96.5% of the rural areas in the suburbs of the city. It can be seen that cooperative medical care is moving towards recovery and development in the vast rural areas.
Establishing a new rural cooperative medical system is a complex social and systematic project. The Chinese Government has taken the approach of first piloting the system, and gradually improving and expanding it. From the perspective of safeguarding the fundamental interests of the vast majority of farmers, the various regions and departments concerned have adapted their work to local conditions, provided classified guidance, and carefully organized and operated the system in order to ensure that the pilot work is promoted in a solid manner, thus laying a good foundation for the healthy development of the new type of rural cooperative medical care. From the pilot region's achievements, the establishment of a new rural cooperative medical system of great prospects can be seen.
-36 billion yuan of consumer power: rural cooperative medical consumer demand waiting to be "released" April 13, 2006
-Shandong Linyi: farmers through the cooperative medical "urban medical" back to their hometowns to reimbursement2006 April 10
-Ministry of Health to carry out comprehensive evaluation of new rural cooperative medical care pilot project March 29, 2006
-Promoting the construction of rural cooperative medical care system to make it no longer difficult for peasants to see a doctor March 29, 2006
-China's rural areas will basically popularize the new rural cooperative medical care system in 2008 Feb. 21, 2006
-Reporter's Shandong survey of rural cooperative medical care: 10 yuan in exchange for the benefits of February 09, 2006
-2010 new rural cooperative medical system will basically cover the rural population January 20, 2006
Because of the weak economic base, lack of experience, farmers' understanding of the bias and other reasons, the new rural cooperative medical system in the country's pilot Advancement is not a smooth sailing boat, the formation of a resistance does not involve a deep wide range of social factors. The first to remove all the difficulties or another way, all levels of government and the relevant management departments are facing a serious test.
-The joy of the confused farmers how to look at the new rural cooperative medical February 08, 2006
-To solve the difficulties of farmers to see a doctor must face up to the five contradictions of rural cooperative medical March 21, 2006
-To visit the pilot of a new type of rural cooperative medical talent shortage is an important pitfall February 15, 2006
- Why the enthusiasm of farmers to participate in the insurance is not high, and why it is not a good thing? Farmers participate in the insurance enthusiasm why not high is only small farmers consciousness do strange?2006年02月08日
-Farmers suffering from uremia family trapped in the big illnesses of the cooperative medical care a drop in the bucket2005年12月06日
-Kidney removal to save her husband: how much pathos and helplessness2005年11月23日
-江西婺源：農"" Signed" to see the sick cooperative medicine difficult to promoteJul 21, 2005
-With or without cooperative medicine - two sick farmers in very different situationsMar 13, 2006
-From the death of the farmer's wife to see the soft underbelly of rural health care: township hospitals do not live up to their names May 09, 2005
-Concerned about rural health care: unpaid bills drag down a township health centerFebruary 28, 2005
-There is really no money to hire people in Gansu, a health center for many years, supported only by a village doctorFebruary 24, 2005
-The new type of rural cooperative medical care in 2010 basically covers rural residentsNovember 11, 2004
-The new type of rural cooperative medical care in 2010 basically covers rural residentsNovember 05, 2004
-From the death of a peasant woman to the weakness of rural medical care. 05 Nov 2004
-Fresh start of China's new rural cooperative medical care there are five major problems November 05, 2004
-Nearly 70 million Chinese farmers to participate in the new rural cooperative medical system November 05, 2004
Extended reading: insurance how to buy, which is good, hand in hand to teach you to avoid the insurance of these "pits"