中国农村医疗保障制度的现状与对策

Challenges and strategies of health insurance system development in rural China

稳定的筹资渠道是农村合作医疗可持续发展的关键,亟待建立与完善。文章通过分析当前中国农村医疗保障政策中存在的主要问题、机遇和挑战,提出政府要借助重建合作医疗这一契机,制定和稳定符合农民根本利益的相关政策,建立和完善可持续的筹资体系。通过重建农村合作医疗制度,构建农村多层次的医疗保障体系,尤其是对贫困农民实行医疗救助,逐步缩小城乡差别,最终实现将农村合作医疗与城镇职工医疗保险对接整合的战略发展目标。

A stable financing source is one of the key factors for the development of the cooperative medical scheme （CMS） in rural China. This paper identifies the problems and causes, analyses the opportunities and challenges that the CMS is currently facing, and makes some recommendations in terms of improving and developing better policies. The government needs to develop policies on the basis of meeting the interests of most farmers and to make sure those policies sustainable. It is essential to establish a stable financing channel to support the redevelopment of the CMS and to develop a multi-level health insurance system which consists of a Medicare scheme for covering the poverty population so that the gap between the poor and rich would be gradually reduced. In doing so, China would be able to achieve the strategic goal of integrating the CMS and the urban health insurance system into a universal system in the future.