西部贫困地区新型农村合作医疗制度运行成效、问题及对策——以湘西土家族苗族自治州为切入点

Operational Performance,Issues and Countermeasures of New Rural Cooperatives Medical Service System in Western Poverty-Stricken Area:A Case Study of Xiangxi Tujia and Miao Minority Autonomous Prefecture

通过6年的实践,新型农村合作医疗制度在西部贫困地区取得了很大的成就,参合率、农民的受益水平不断提高,新农合制度框架及运行机制日臻完善。然而,西部贫困地区新农合在运行中的逆向选择、道德风险问题不容忽视,高筹资成本和基层政府低财政能力之间的矛盾亟待解决。完善西部地区新农合制度应考虑采取强制性原则,积极探索农民个人筹资长效机制,实行"住院统筹+门诊统筹"的补偿模式。

Through 6 years practice, the new rural cooperatives medical service system has made great achievement in the western poverty - stricken area. The rate for joining the cooperative groups and farmer＇s benefited level enhances unceasingly, and the new rural cooperative medical service system and the operational mechanism are much more improved. However, the operational reversion choice and morality risk in new rural cooperative medical service system of western poverty - stricken area should not be neglected, and the contradictions between the high financing cost and the low finance ability of governments at the grassroots level need be solved as early as possible. In order to improve the new rural cooperative medical service system of western poverty - stricken area, we should take the compulsory principle into consideration, actively explore the long -term effec- tive mechanism of farmers＇ individual fund - raising and implement the compensation pattern of ＂hospital overall plan ＋ outpatient service overall plan＂.