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1、On the Administrative Law from the Perspective of the new rural cooperative medical system in the development of Paper Keywords: new type of rural cooperative medical care system innovation of administrative law Abstract: Implementation of the new rural cooperative medical care system is an administ
2、rative guide behavior. Overall, the new rural cooperative medical system is running well. Publicity deep enough and peasant self-care, awareness Huzhugongji weak and other factors involved in this system, the farmers enthusiasm; inadequate design of the system affected the farmers benefit from the c
3、overage and benefit levels. To achieve system innovation, to step up publicity efforts to improve management efficiency and the establishment of systems of administrative supervision is to improve the new rural cooperative medical system in a reasonable path selection. New-type rural cooperative med
4、ical system is run by governmental organizations, guidance and support, farmers voluntary, individual, collective and multi-government funding, to more serious medical co-ordinate the content of the farmers as the main system of health care Huzhugongji. From the perspective of the system of administ
5、rative law should be straightened out to understand the status of implementation of this system, successful experiences and problems, in order to constantly improve the new rural cooperative medical care system to provide decision-making basis, to more than 800 million farmers will benefit the healt
6、h of the system of the development of great significance. A system design: the interpretation of a village in Zhejiang Province from the second half of 2003, Chinas 30 provinces and cities across the country have chosen more than 300 counties of the new rural cooperative medical system in the pilot.
7、 In this context, a village in Zhejiang in 2004, 5,6 month to start building on July 1, 2004 implemented the new rural cooperative medical care system. 1.1 to participate in new-type rural cooperative medical care system objects. Apart from having to participate in the basic medical insurance system
8、 for urban workers and staff, the other village, the agricultural population in the register may participate in the new rural medical care. Persons who meet the above conditions, has participated in commercial insurance, you can also participate in new-type rural cooperative medical care. 1.2 Fund r
9、aising standards. 40 yuan per person per year of the new cooperative medical care funds from the county-level city finance, rural finance and village collective economy and individual farmers to raise the Quartet. County-level city finance, rural finance according to the actual number of participant
10、s, the support given to 20 yuan per person per year; village collective economic according to the actual number of participants, support for 5 yuan per person per year; to participate in cooperative medical service personnel are the entire household as the unit per person per year pay Qiao Yuan. Hom
11、es for the elderly in homes for the elderly, households enjoying five guarantees, and enjoy the minimum living guarantee farmers pay part of their personal finances by the county-level cities and towns to share the financial 10 yuan each; persons with disabilities of their individual contributions i
12、n part by the county-level cities Federation of Disabled Persons responsible for solving . 1.3 the Fund to follow open and transparent management principles. Municipal Agricultural Office on a regular basis to settle medical cooperative medical fund income and expenditure accounts, set out a detaile
13、d list of concurrency to the township peoples governments, from township government office in charge of agricultural medicine column published in the village village affairs. 1.4 the proportion of Medicaid. To participate in the new cooperative medical personnel, medical institutions in the city hos
14、pital designated by the health insurance cost of medical expenses (in line with requirements within the scope of subsidies) by the following criteria in order to be supplemented by sub-method of calculation: 500 million (including 500) the following part of the no benefits; 501 a 3,000 a section, yo
15、u can grant 20%; 3001 a portion of 6,000 yuan can grant 30%; 6001 part of a 10,000 yuan may grant 40%; 10,001 yuan or more section, you can grant 50% . In Linan medical insurance outside of designated hospitals for treatment, according to the above criteria for% a subsidy. Hospitalized several times
16、 can be accumulated. The maximum grant amount of 20,000 yuan. 1.5 out of medicines reimbursed. To participate in cooperative medical service personnel, designated in the health insurance treatment of township hospitals, their medical expenses (excluding drugs at their own expense) on the spot knot r
17、eported by 10%. Who is no longer listed in this part of the cost as subsidy to the above-mentioned sub-grants. 1.6 The procedures for handling medical expenses assistance. In the billing period (billing period is one year) are eligible for subsidies occurred medical expenses, will be the hospital di
18、agnosis and treatment of the original invoice (including the cost ledger single, consolidated list drugs), medical history, the cooperative medical card, ID card I sent to the township peoples Government agricultural doctor to do, by the township government office on behalf of his handling of agricu
19、ltural medicine. 2 Implementation: The analysis of a village in Zhejiang Province 2.1 Performance Analysis. 2.1.1 farmers in the enthusiasm of the new rural cooperative medical care is high. Village 1504, with the total number of 1397 insured persons, the insured rate was 93%. 2.1.2 The village has
20、enjoyed compensation for new-type rural cooperative medical care accounted for a large proportion of farmers. L from July 2004 to December 31, the village has more than 14 farmers had reimbursed medical expenses, the cumulative total of 25,892.11 yuan reimbursement. 2.1.3 farmers have shown great en
21、thusiasm. Asked farmers, You of this work How satisfied?, The answer was satisfied and accounted for 77% answered satisfied and accounted for 19%, answered dissatisfied and only 4%. 95% of the surveyed farmers said that next year, they had to attend, and only 0.2% of the farmers said definitely not
22、participate in next year. 2.2 The problem analysis. 2.2.1 Publicity deep enough constraints insured rate of the farmers. Farmers for new cooperative medical care system in the community is still relatively vague, involving the vital interests of the regulations and systems can not accurately tell. T
23、he survey, only 46% of the farmers know that reimbursement for medical expenses needed for the procedure, while 20.8% of rural households do not know. 70% of households answered somewhat clear or not sure the amount of reimbursement of medical expenses how it was calculated. Outpatient and inpatient
24、 reimbursement caused by the difference between the proportion of farmers cooperative medical reimbursement between expectations and the actual reimbursement amount of the gap created beyond imagination; Some farmers worry that the insured can not go by the post-hospitalized cash compensation, worri
25、ed that funds were diverted , which have reduced the rate of insured. 2.2.2 inadequate system design, affecting the farmers benefit from the coverage and benefit levels. There are four more farmers to reflect aspects: First, the proportion of low reimbursement. Compensation less the cost of the farm
26、ers themselves, or emphasis; second is to pay for medical expenses reimbursed from line, cap line of scientific development. Deductible line set too high, farmers worried about minor ailments do not benefit the farmers insured enthusiasm, capping line set too low, farmers worried about more serious
27、insecurity, can not fundamentally solve the problem; third is too cumbersome reimbursement procedures. In particular, transfers of the need to go through layers of links, the farmers are more opinions; four designated hospitals on the provision limits the right of farmers to choose the hospital is n
28、ot conducive to the medical unit health care standards and quality of service improved. Reposted elsewhere in the paper for free download http:/ 2.2.3 fixed cooperative medical institution pharmacy drug prices above the market, farmers are more strongly reflected. The current rural health care costs
29、, pharmaceutical costs typically account for 75% a 85%. A considerable number of designated hospitals is much higher than the market price of drugs pharmacies. Insured farmers occurred in drug costs of cooperation in medical claims, still higher than the pharmacy retail price, to a certain extent, a
30、ffected the farmers in the new rural cooperative medical care initiative. 3 thoughts and recommendations: strengthening of administrative control, and establish a virtuous circle mechanism of the system 3.1 to strengthen organization and leadership, strengthening propaganda and education work. Shoul
31、d unify our thinking, and strengthen the rural cooperative medical care organization and leadership and advocacy education. New-type rural cooperative medical system is one involving thousands of households to maintain the hearts and minds of millions of peasants project can really welcomed by the m
32、asses of the people, can have a strong vitality, the key is the masses of our work can be recognized and trust. Should face social communication, expanding the communitys new-type rural cooperative medical awareness and encourage community donations, funds from various sources. 3.2 sound system desi
33、gn, implementation, system innovation. Must promptly in-depth understanding and analysis of farmers to new rural cooperative medical system in existing doubts and opinions and to promptly absorb the reasonable requests and suggestions to improve system design. To expand the scope of out-patient reim
34、bursement, and mobilize their enthusiasm insured. Where information on the basis of certain information, through analysis and timely adjustment of compensation standards to improve the level of benefit the farmers; to gradually reduce and effectively control the designated medical institutions, drug
35、 prices, to minimize drug prices. Strengthen the medical staff of professional ethics education to prevent human side, large prescription and repeat the inspection, effectively reduce the medical burden of the peasants; to local conditions of women and children in rural areas to help specific groups
36、 of women in some rural common examination and treatment of diseases, birth and other developed some special care policies. No medical expenses for the year to provide free medical examination farmers. 3.3 The improvement of rural health care conditions and services based clumsy mode of medical trea
37、tment to reduce the burden on farmers. To adjust and optimize health resources in rural areas, speed up the reform of service delivery model. Role of market mechanism, and mobilize and encourage the participation of social forces to set up rural medical and health undertakings. Focus on strengthenin
38、g the township and village health care institution-building, and gradually complete the necessary medical and health facilities, and reasonable to adjust and optimize health resources in rural areas, speed up service delivery model to improve rural health institutions to speed up community health se
39、rvices in rural areas. To increase investment in rural health and increase health support agriculture. To encourage outstanding graduates of medical schools to rural hospitals, constantly raising the township and village health facilities and level of medical service capacity. 3.4 The establishment
40、of systems of administrative supervision, and network management, improve management efficiency. New-type rural cooperative medical care related to capital management policies, will inevitably encounter financial income, management, on how to use a transparent and open question. To establish a rural
41、 cooperative medical care information management platform for the rural cooperative medical care information technology and network management. Faced with an enormous insured group must implement the information technology and network management, medical office will be located in the township health
42、 centers of agricultural lobby, farmers pay for medical treatment in the registration window, another window, reimbursement, the audit carried out automatically by a computer, one views reimbursement of a few minutes to complete. This has not only enhanced the transparency of financial operations, reduce management costs, improve management efficiency, but also to avoid the drawbacks of manual review claims to ensure that accurate data to facilitate the farmers reimbursement. Reposted elsewhere in the paper for free download http:/
