新型农村合作医疗的参合补助——悖论及路径优化

The Fiscal Subsidies in the New Rural Cooperative Medical Care System:A Paradoxical and Path Optimization

新农合的财政补助水平与农民需求存在较大缺口,客观上需要政府提高补助水平。但由于农民有限理性的存在,在个人缴费在先且与财政补助同比增长的制度安排下,形成了农民既需要参合补助,又不愿因增加个人缴费以获得补助的悖论,且此情况会因制度供给缺陷而激化。因此,需要对新农合的参合补助路径进行优化。设计灵活的参合缴费模式,调整农民缴费与政府补助的增长幅度,提高农民医疗补偿的比例都是可行的选择。

There is a big gap between the amount of fiscal subsidies in the New Rural Cooperative Medical Care System （NRCMCS） and the demand of the farmers, and there is an objective need for the government to raise the subsidies. But as farmers＇ limited rationality and individual contributions to the earlier and the same proportion of growth and financial assistance, a paradox was formed that farmers need the medical subsidies from the government but at the same time, they do not want to pay more. And the paradox becomes more serious because of the supply deficiency in policy. Thus, an optimized allocation is needed for the fiscal subsidies in the NRCMCS. There are many feasible ways in allocating the subsidies, such as designing flexible ensuring modes, adjusting the increase range between the farmers＇ payment and government subsidies, raising the proportion of farmers＇ medical reimbursement, etc.