中国农村医疗救助的目标定位与覆盖率研究

Targeting and Coverage Rates of Medicaid in Rural China

依照农村医疗救助的制度安排,所有目标定位群体的人员均可免费参加新型农村合作医疗,其新农合参保费由政府通过专项财政经费来支付。这是实现医疗救助与新农合衔接的首要环节,对强化我国农村医疗保障体系意义重大。本文从目标定位标准设定与覆盖水平两个方面,比较分析了2006-2013年各省资助农村贫困人群参加新农合的实际效果和地区差异。研究结果显示,尽管资助参合的覆盖率逐步提高,但农村贫困人口中应该救助但却没有获得救助的情况仍然相当严重。在不少省份,医疗救助制度业已定位的人群未能获得参合资助的比例竟然高于50%。特别是2009年以来,不少省份不仅未能落实中央政府推动资助范围由贫困弱势群体向低收入群体扩大的要求,反而降低了对既有救助群体的资助参合覆盖。巩固提高基本目标定位人群获得财政资助免费参加新农合的覆盖率,并逐步将低收入群体纳入资助参合的范围,是推动医疗救助体系巩固完善的关键。

At the center of Rural Medicaid is to ensure targeted people to enroll in the New Rural Corporative Medical Sys- tem （ NCMS）, a publicly subsidized voluntary social health insurance program. By analyzing provincial - level data from 2006 to 2013, this paper examines the effect of Rural Medicaid＇ s targeting, and reveals provincial disparities over the coverage rates. Research findingsindicate that the functioning of Rural Medicaid＇ s target- ingwasrather poor in that manytargeted people actually enjoyedno benefits. In many provinces, the ratio of those who were targeted by governments but eventually failed to be sponsored was over 50%. In particular, since 2009, many provinces have failedto expand Rural Medicaid＇ s coveragein accordance with the central govern- ment＇ s requirement, and even in some provinces governments to give priority to consolidateexisting ral residents in China. the coverage rates have further lowered. It is critical for local coverage ratesof Medicaid, and to covermore low-income rural residents in China.