Our country's new rural cooperative medical service compensates the mode and establishes

Our country's new rural cooperative medical service compensates the mode and establishes
Our country's new rural cooperative medical service compensates the mode and establishes
China's new rural cooperative medical service (hereafter referred to as " Shut newly and agriculturally " )Pool last scheme,last management on is normal. The staff reporter learns, the rural hygiene department of Chinese Health Ministry has already entrusted and launched " comprehensive arrangement for serious disease and clinic pool combine together " Launch a pilot project research. This is March of this year, vice-premier Wu Yi advances one of the new agricultural three major subjects that assign jointly, relevant to work May is started formally. Recently, this subject leader, public health Hu Shan, professor of institute of Fudan University that just surveyed and studied back from Hubei unite and tell reporters, launch to survey and study table, issue get each province already in writing situation about domestic the intersection of clinic and pool; The seminar is in 25 counties (market) of 8 provinces in the whole country separately at the same time Carry on on-the-spot study. It is estimated the whole subject is finished in December of this year. When the time comes, the seminar will take out the new agricultural " instruction " that shuts the pool of clinic to standardize management . It was the 2003 of the trend of the times that family's account was faded out from, China set about to pursue the new rural cooperation medical treatment system. In initial stage of pilot project, in order to arouse the enthusiasm that peasantry joined shutting, all parts mostly implemented" family's account is added and in hospital the pool " Compensation mode. In the Midwest, the proportion of family's account is up to 80- 90%. The function that practice shows family's account is limited - -Investigation find general method of all parts pay the fees peasants' individual all or most is put under family's account, peasants are thought to diagnose the illness to spend one's own money, quite a lot demonstrate " save " Will,it is precipitate in a large amount not to last account that the funds. The public data of department of public health of Anhui Province reveal, what all parts set up is used in the family account that the clinic compensate, 75% of the the above has fund to precipitate; By the look of fund number, the fund of family's account has only used 19%, other 81% of the fund accumulation. That is to say, a lot of ginsengs are shut to peasants and has not used family's account fund to pay the hospitalization cost of the clinic, thus has influenced new agricultural benefited one shut directly. The statistics show, Anhui the whole province 43 million join, shut in the peasant, only less than to in hospital peasant to be benefited 4% every year. At the beginning of 2008, department of public health, the General Office of Finance of Anhui Province will jointly issue " the new rural cooperative medical service of Anhui Province compensates the implementing scheme ", stipulate the new compensating the way newly and agriculturally jointly of the whole province, propose from 2008, the whole province cancels and shuts family's account newly and agriculturally progressively, make the transition to the pool of clinic as soon as possible, should all implement the pool of clinic by 2010. Hu ShanLian thinks, the overwhelming majority is joined and shut to peasants and can not be compensated, will influence them to join the enthusiasm shut, and then jeopardize the consolidation of the rural cooperation medical treatment system, this is launched " comprehensive arrangement for serious disease and clinic pool combine together " One of the original intention of the subject for research. Reveal according to the media, already a plurality of provinces such as Hubei, Hunan, Shaanxi, Gansu, Chongqing, Jilin, Zhejiang, Jiangsu have begun the pilot work of the pool of clinic successively at present, it has already been the trend of the times that family's account is withdrawn from. But current the intersection of clinic and pool compensate the mode, sure defect stores in even. According to the expert's view, the pool of ordinary clinic is managed as a whole by county, take in proportion, regard joining and shutting to individuals as unit, calculate, bind line, way that check and calculate by family, subsidize. But the real situation is, the little part implements the counties and cities of the pool of clinic, pay the system the total value taking villages and towns as accounting unit, the total value of the fund is too low, present the risk of running very easily; To sick peasant, each clinic of each person compensates and binds the line generally in under 10 yuan, bind the line in under 200 yuan totally in one year, this money may be said that as ridiculously inadequate effort to save a grave situation. Hu ShanLian thinks, the pool of clinic can be raised and joined and shut peasants' benefited rate, compensate the future developing direction of the mode newly and agriculturally jointly. Pilot project this it studies to be to take on the basis of current situation of finding out, make system this move towards normal complete. Investigation of the end of 2006 show, of our country 1/3 county (city), area of east, at that time , and about 5% of the counties (market) of poverty-stricken area Have implemented the pool of clinic. Whom seminar issue survey and study table in writing this time, to the intersection of the whole country and more thanth county Pay and know the real situation in an all-round way the situation of the pool of clinic. The experiences of public security men: The pool of clinic was compensated the 2004 of pilot project, the public security men in Hubei county was while compensating family's account of the clinic, compensate the pilot project after launching the pool of clinic, the pilot range is expanded to 13 villages and towns in 2007 progressively by 2 initial villages and towns. At shutting the working conference newly and agriculturally in the whole country in March of 2008, the public security men county makes and exchanges and makes a speech as the typical case. The clinic pool fund of public security men county, according to joining and shutting fund-raising of 15 yuan for each person every year of number of people, check and calculate by villages and towns, manage in unison the whole county. The clinic pool fund is divided into clinic medical compensation payment and risk money, among them the medical compensation payment of the clinic accounts for 95%, used for joining and shutting peasant's compensation of clinic hospitalization cost; The money of risk accounts for 5%, is used the medical fee of the clinic and compensated the supplement after appearing and overdrawing. When the money of risk reaches the clinic pool fund 10% of those years totally, no longer draw. The hospitalization cost of peasants' clinic is compensated in proportion: Join and shut peasants and seek medical advice in the village clinic, clinic of health clinics in towns and townships due to illness, can get 25%, 30% of the expenses to compensate separately, each person pays for the ceiling of 7- 12 yuan totally every day. The pool of clinic makes public security men's clinic fund rate of utilization of the county improve notably - -From January of 2004 to November of 2007, the clinic fund rate of utilization of villages and towns of the pool of pilot clinic was 94.5%, the villages and towns paying the mode for family's account in the same term, this figure is 77.4%. Meanwhile, join and shut peasants' going to a doctor rate of clinic and rise. When the whole county implemented family's account in 2003, joined and shut peasant's annual per person's clinic to go to a doctor the number of times was 0.3 timesed; The villages and towns implementing pool of clinic in 2006, joined and shut peasant's annual per person's clinic to go to a doctor the number of times was 1.99 timesed, achieved the result of guiding the rural hygiene resources at the basic level of peasant's rational utilization at the same time too for this 1.96 times in 2007. The method of Hubei has already been imitated by many places. It is reported, have shut and already newly and agriculturally developed four kinds of main compensation modes now: First, only compensate the expenses in hospital; Second, compensate expenses and large volume expenses in hospital; Third, compensate with the clinic expenses in hospital; Fourth, compensate the expenses in hospital, adopt the personal account of the clinic at the same time. ShanLian Hu reveal eastern area have 33% pilot county compensate, in hospital expense only in relevant research for 2007, but the pilot county of the central and west regions has all adopted and in hospital and clinic balanced approach. Fudan University obtains employment and seals and enters a latest research that the associate professor presides over to point out with the research center of the social security: As to treating oneself, people Would like to choose the clinic instead of in hospital further, this is because the indirect expense included in hospital can't be ignored either. The simulation of different compensation schemes of this research shows, only compensate in hospital the expenses can not lighten the average medical burden, under replenishing government on the same situationing,clinic and compensate in hospital? J Let ���� be disrespectful? Further standardize the management moustache and good at uniting and saying, " comprehensive arrangement for serious disease and clinic pool combine together " The task of the seminar, it is the successful experience to be summarized all parts, form to shutting the standardard management that the pool compensates the mode newly and agriculturally finally. This including several important problems. It is the fund proportion between the pool of clinic and comprehensive arrangement for serious disease at first. Hu ShanLian points out, leads in hospital and are up to 7- 9% in some places, exceeds 3- 5% of the average national levels greatly, obviously with compensate the mode, arrange for improperly and relevantly. Secondly it is the system that the clinic compensates that arranges. The methods of all parts are roughly to shut and arrange to offer some fund in pool funds agriculturally again at present, the special compensation used for clinic expenses, the rank of the medical organization " submits an expense account in proportion" according to going to a doctor . Issue that seminar pay close attention to, person who serve, increase, expenses that clinic wipe out how about control in the future? Hu ShanLian thinks, some " bind appropriately " already tried in place , " total value is controlled " ,Method summarizing that one worth. Implementing the pool of clinic will also face the moral hazard problem, namely the medical insurance may impel people's excessive consumption, thus it is difficult to realize to cause the self- equilibrium of Medical Benefits Funds. The research that is sealed into shows, in paying the medical insurance made together, rise to the hospitalization cost when it is about 20% to pay for itself leadinging and have obvious containment function. " it is a very important problem to confirm the rate appropriately and submit an expense account " ,She says. Seal into to point out, the existence of the medical insurance has reduced the real price of medical consumption, but relax the fund to restrain at the same time, will make the medical service price rise under certain condition, must not reduce the medical treatment of peasant and patient to bear. Hu ShanLian says, the seminar will consider this to some extent too: " supervise to doctors and patients both sides " . To compensating the mode more and breaking up, lacking the phenomenon that relatively seeks unity of standard, Ministry of Public Health puts forward the requirement in shutting the working conference newly and agriculturally of 2007: The area to launch the cooperative medical service adjusts and compensates the scheme actively, explore that solves benefited one and contradiction of the benefited intensity. This concerns 730 million and joins and shuts peasants' vital interests.


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