新型农村合作医疗筹资瓶颈破解:制度解析与重构

To Break Through The Bottleneck of New-type Cooperative Medical Schemes In Rural China:System Analysis and Reconstruction

新型农村合作医疗筹资瓶颈是制约其发展的关键和核心问题。当前新型农村合作医疗筹资困境的成因主要源于制度设计层面,其制度性缺陷主要表现在制度本身的社会保险性质的弱化;三方筹资主体的筹资责任、筹资标准、筹资比例界定难;基金监督与管理的法律依据缺失等方面。必须对制度进行重构才能实现可持续运转,而不是简单的修修补补。

The fund-raising bottleneck of the new-type cooperative medical schemes （NCMSs） in rural China is the key to restrict its development. Currently, the dilemma of fund raising in the NCMSs mainly results in the system design itself. Its system flaws mainly include： the attenuation of social security archery target of the system itself; the difficulty of limiting finance responsibility, finance standard and finance proportion to the main body in tripartite finances; the lack of legal basis in fund surveillance and management and so on. We have to carry on reconstructing the system to make it sustainable development, which is not suitable to patching up simply. Therefore, we should re-limit fund-raising responsibility of the main body in tripartite finances, strengthen its social security essence, and strengthen government finance responsibility, strengthen surveillance and the management. Especially, we must take urgent action to formulate the powerful law to take the strut.