中国农村合作医疗的演进与反思

Evolution and reflection of Chinese rural cooperative medical system

目的研究中国农村合作医疗的演进,从中寻求对于新型农村合作医疗健康持续发展可资借鉴的因素。方法文献资料考证、数据统计和分析。结果以中国多数农民能得到较好的医疗保障为标志,将中国农村合作医疗划分为1949—1978年传统农村合作医疗发展、1979—2002年传统农村合作医疗衰退、2003年至今新型农村合作医疗崛起3个阶段。结论政府能否制订适应国家经济基础的合作医疗制度、强有力的组织和承担主要筹资责任,是传统农村合作医疗兴衰的关键,也是当前正在实施的新型农村合作医疗制度健康运行和可持续发展需要汲取的经验和教训。

Aim To study the evolution of China′s rural cooperative medical system（RCMs）,and from which to seek reference for the healthy development of the new RCMs.Methods Analysis of historical documents and statistics.Results Taking most of the farmers can get better medical care as the logo,China′s RCMs could be divided into three stages,1949—1978 to be the form of RCMs,1979—2002 to be the decline of RCMs,and since 2003 to be the rise of the new RCMs.Conclusion Whether the government to design the cooperative medical system to meet the country′s economic need,to organize it strongly and to assume the primary responsibility for fund-raisng,was the key to the raise and fall of the traditional rural coopeative medical system,and the lessons to learn for the healthy and sustainable development of the new rural cooperative medical system.