推进新型农村合作医疗制度的约束性探讨

Thoughts of Restrictive Terms on the implementation of the New Rural Cooperative Medical Service System

尽管我们在理论上能够阐明实施新型农村合作医疗制度的意义、试点的目标和要求、资金筹集和监管机制、医疗管理能力建设要求、完善农村卫生服务体系目标，但是在实施新型农村合作医疗制度的实践中，我们却必须要首先解决诸如属性不明确、目标定住模糊、宣传推动成本高、难度大、农民健康保健及风险共担意识淡薄、医疗机构行政管理能力较弱、对医患双方道德水准的担忧、立法工作滞后、定点医疗机构服务水平较低、筹资机制缺乏可操作性、政府责任意识不强等因素的制约。否则，新型农村合作医疗制度的推进将会受到阻碍。

Although we can illustrate the signification of carrying the new rural cooperative medical system, the goal and request of the experiment, the mechanism of fund raises and supervision, the requirement of medical management ability construction and the goal of perfecting rural health service system in theory. However, during the practice of carrying the new rural cooperative medical service system, first we must solve these issues, such as： the ambiguousness of the attribute, the fuzziness of target location, the high cost and much difficulty of propaganda, the weak sense of peasants＇ heath care and shared risk, the weak administrative capacity of medical institutions, the worrying of doctor-patient moral standards, the lag of legislation, the low service level of designated medical institutions, the lack of operability in fund raises system and the weak responsibility consciousness of the government. Otherwise, the implementation of the new rural cooperative medical service system will be hindered.