完善吉安市新型农村合作医疗运行机制分析研究.pdf

摘要 摘要 近年来，面对农民医疗费用不断攀升、农村医疗机构服务质量低下的现实 情况，面对农民因病致贫返贫现象严重、农村基本医疗保障体制缺失的严峻形 势，新型农村合作医疗在建立一个人人可及又行之有效的农村医疗体制，解决 农民看病难、看病贵这个重大难题方面，取得了令人瞩目的成绩。并且，该项 新兴制度以其蓬勃的制度生命力迅速发展，短短 6 年时间就覆盖了全国所有县 （市、区）。关于该项制度在试点过程中取得的成效和面临的问题，国内许多专 家、学者已作了比较深入的研究，论著颇丰。本文以吉安市新型农村合作医疗 运行情况为研究实例，考察该市新型农村合作医疗发展现状，探究该市新型农 村合作医疗运行过程中存在哪些问题及其对合作医疗运行造成哪些不利影响， 探索完善该市新型农村合作医疗运行机制的对策建议。 本文研究的重点在于综合运用定性分析和定量分析方法，探讨吉安市新型 农村合作医疗实际运行中存在的问题。在对吉安市新型农村合作医疗的保障水 平、基金运行水平、制度供给水平、市场供求水平进行系统评价的基础上，对 影响新型农村合作医疗持续健康发展的关键性因素进行剖析。同时，着力于完 善吉安市新型农村合作医疗运行机制对策的研究，提出改革现行参合方式和门 诊费用补偿方式等建议，并进一步探索建立长效筹资机制、健全管理体系和提 高农村医疗服务能力的对策措施，同时在配套制度完善方面，创造性地提出设 立“再保险基金”，将大病风险向商业保险机构适度转移。 关键词：新型农村合作医疗;机制;建议 I Abstract ABSTRACT In recent years, the new-type of rural cooperative medical system (NCMS) has made remarkable achievements in the important term of building a well-established health care system in rural areas to solve the difficult problem of farmers’ medical services being unaffordable and inadequate. when facing the actual conditions of rural rising medical costs, low quality of service of rural medical institutions and the grim situation of phenomenon on farmers turning into poverty once again or being impoverished by hospitalization and lacking of basic medical security system in rural areas .And, The new system developed rapidly for its vigorous vitality in just six years to cover all the nations counties (cities, districts). Many domestic experts and scholars have made a more in-depth study on the achieved results and encountered problems of the system in the pilot course, and had rich works. The paper studied instances of NCMS operation to investigate its actual dev