福利经济学视角下新型农村合作医疗发展研究
目 录
ABSTRACT
Medical system reform in our country has carried out more than 30 years, 15 years have been introduced in the new rural cooperative medical care system.After years of development, in establishing and perfecting the medical security mechanism, improve peoples health level, etc has made great achievements, but also exposed the problems in the middle of the reform process.For example: medical infrastructure construction is not perfect, the doctor-patient relationship nervous, unreasonable resource allocation, etc.How to better health care system reform, the government needs to solve a difficult problem.In this paper, from the perspective of welfare economics, using research methods of literature analysis, comparative analysis, through the analysis of the development of Chinas new rural cooperative medical system implementation situation, the reform process of exposed problems and shortcomings, to efficiency and fairness appropriate consideration, constantly
*好棒文|www.hbsrm.com +Q: *351916072*
ment of Chinas new rural cooperative medical system implementation situation, the reform process of exposed problems and shortcomings, to efficiency and fairness appropriate consideration, constantly to alleviate contradiction between supply and demand, resource allocation more reasonable as the goal, for the government to carry out medical and health system reform, the market is crucial, the government cooperate with supervision, etc.Pharmaceuticals price regulation by market supply and demand, quality of service to peoples satisfaction as the standard, and strive to build a more perfect rural medical security system mechanism, safeguard farmers health, etc are studied, and put forward the related Suggestions and operability of the measures to solve some specific problems.
Key words： Welfare economics；New Rural Cooperative Medical Care； insurance；
一、引言
（一）研究背景与意义
1.研究背景
随着我国卫生服务体制创新的推进，对新型农村合作医疗改革进行了深入探索，尤其是在乡村医疗基础设施建设完善、服务体系的创新、保障国民身体健康等方面得到了巨大突破，医疗红利日益凸显。但是，由于各方面的原因，在改革过程当中仍然有很多问题仍需解决。例如，医患关系矛盾日益凸显，医药成本过高、部分医药报销比例太低甚至不予报销，医疗资源供需不合理、不均衡等。如今，中国的医疗体制改革已经进入到关键时期，伴随着社会各方面改革的推进，如何推进，怎样推进是政府面前的一道难题，也是人民群众密切关心的问题。
2.研究意义
我国医疗卫生事业改革是重大的民生工程，改革取得成功有利于改善民生，改革停滞不前则会影响农村医疗保障水平进而影响社会主义新农村建设。因为我国人口众多并且基数大，其中农民所占比例较大。新型农村合作医疗改革的推进，是社会主义新农村建设当中的又一股春风，国家提出要努力构建医疗卫生创新体制，健全医疗服务体系，对增强农民的身体素质、建设和谐社会具有重要意义。
（二）国内外研究现状
1.国外研究现状
Swenson, Penter (2011)研究了美国的公共卫生服务体系，尤其是在医疗卫生费用支出控制方面。认为医疗卫生保障要实现可持续发展，需要全方位的管理能力，对此引入了公共卫生服务管理理念，还分析了公共医疗卫生的管理理念需要借鉴的方法，在此基础上探索公共医疗卫生的服务社会化。Fiona Ferguson（2012）分析德国的农民医疗保障由政府委托国内的医疗保险机构来承办，服务质量较好、效率较高，为全国的农业人口提供了较为完善的医疗保障。Fossertt,JamesW（2014）提出在英国的社会福利是非常高的，享受着全民免费医疗。医疗卫生事业是受政府高度关注和支持的，医疗机构的运行机制比较完善，从业人员的认证标准比较严格，风险管控严厉，国家统筹负责。结果就是，英国公民可以用及其低廉或免费的成本来享受医疗福利。
2.国内研究现状
（1）关于新型农村合作医疗现状的研究
李向东（2010）研究了我国新型农村合作医疗存在的一些问题，提出农村的公共卫生服务保障水平远低于城市，资源配置不合理。其中最主要的原因是农民收入低。宫春晓（2011）从社会保障水平方面阐述了新型农村合作医疗在社会中的重要作用。认为政府的作用不可忽视，必须要配
ABSTRACT
Medical system reform in our country has carried out more than 30 years, 15 years have been introduced in the new rural cooperative medical care system.After years of development, in establishing and perfecting the medical security mechanism, improve peoples health level, etc has made great achievements, but also exposed the problems in the middle of the reform process.For example: medical infrastructure construction is not perfect, the doctor-patient relationship nervous, unreasonable resource allocation, etc.How to better health care system reform, the government needs to solve a difficult problem.In this paper, from the perspective of welfare economics, using research methods of literature analysis, comparative analysis, through the analysis of the development of Chinas new rural cooperative medical system implementation situation, the reform process of exposed problems and shortcomings, to efficiency and fairness appropriate consideration, constantly
*好棒文|www.hbsrm.com +Q: *351916072*
ment of Chinas new rural cooperative medical system implementation situation, the reform process of exposed problems and shortcomings, to efficiency and fairness appropriate consideration, constantly to alleviate contradiction between supply and demand, resource allocation more reasonable as the goal, for the government to carry out medical and health system reform, the market is crucial, the government cooperate with supervision, etc.Pharmaceuticals price regulation by market supply and demand, quality of service to peoples satisfaction as the standard, and strive to build a more perfect rural medical security system mechanism, safeguard farmers health, etc are studied, and put forward the related Suggestions and operability of the measures to solve some specific problems.
Key words： Welfare economics；New Rural Cooperative Medical Care； insurance；
一、引言
（一）研究背景与意义
1.研究背景
随着我国卫生服务体制创新的推进，对新型农村合作医疗改革进行了深入探索，尤其是在乡村医疗基础设施建设完善、服务体系的创新、保障国民身体健康等方面得到了巨大突破，医疗红利日益凸显。但是，由于各方面的原因，在改革过程当中仍然有很多问题仍需解决。例如，医患关系矛盾日益凸显，医药成本过高、部分医药报销比例太低甚至不予报销，医疗资源供需不合理、不均衡等。如今，中国的医疗体制改革已经进入到关键时期，伴随着社会各方面改革的推进，如何推进，怎样推进是政府面前的一道难题，也是人民群众密切关心的问题。
2.研究意义
我国医疗卫生事业改革是重大的民生工程，改革取得成功有利于改善民生，改革停滞不前则会影响农村医疗保障水平进而影响社会主义新农村建设。因为我国人口众多并且基数大，其中农民所占比例较大。新型农村合作医疗改革的推进，是社会主义新农村建设当中的又一股春风，国家提出要努力构建医疗卫生创新体制，健全医疗服务体系，对增强农民的身体素质、建设和谐社会具有重要意义。
（二）国内外研究现状
1.国外研究现状
Swenson, Penter (2011)研究了美国的公共卫生服务体系，尤其是在医疗卫生费用支出控制方面。认为医疗卫生保障要实现可持续发展，需要全方位的管理能力，对此引入了公共卫生服务管理理念，还分析了公共医疗卫生的管理理念需要借鉴的方法，在此基础上探索公共医疗卫生的服务社会化。Fiona Ferguson（2012）分析德国的农民医疗保障由政府委托国内的医疗保险机构来承办，服务质量较好、效率较高，为全国的农业人口提供了较为完善的医疗保障。Fossertt,JamesW（2014）提出在英国的社会福利是非常高的，享受着全民免费医疗。医疗卫生事业是受政府高度关注和支持的，医疗机构的运行机制比较完善，从业人员的认证标准比较严格，风险管控严厉，国家统筹负责。结果就是，英国公民可以用及其低廉或免费的成本来享受医疗福利。
2.国内研究现状
（1）关于新型农村合作医疗现状的研究
李向东（2010）研究了我国新型农村合作医疗存在的一些问题，提出农村的公共卫生服务保障水平远低于城市，资源配置不合理。其中最主要的原因是农民收入低。宫春晓（2011）从社会保障水平方面阐述了新型农村合作医疗在社会中的重要作用。认为政府的作用不可忽视，必须要配
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