Investigation Report on New Rural Cooperative Medical Insurance 1 During the winter vacation, I read a lot of information about the new rural cooperative medical insurance on the Internet. Knowing some achievements made in China's farmers' security system in recent years, I decided to make a simple investigation on the current situation of rural cooperative medical care in China during the winter vacation. I made a simple questionnaire survey on the new rural cooperative medical system, consulted the knowledge about the new rural cooperative medical system, and analyzed the farmers' main views on medical security. Generally understood as follows:
First, about the new rural cooperative medical system.
New rural cooperative medical care? New rural cooperative medical system? , refers to the organization, guidance and support by the government, farmers voluntarily participate, individuals, collectives and the government to raise funds, with serious illness as the main medical mutual aid system for farmers. Take individual contributions, collective support and government funding to raise funds.
The new rural cooperative medical system is a medical security system created by farmers themselves in China, which has played an important role in ensuring farmers' access to basic health services, alleviating poverty caused by illness and returning to poverty due to illness. It provides a model for common problems in the world, especially in developing countries, which is not only welcomed by farmers at home, but also well received internationally. The new rural cooperative medical system has been piloted in some counties (cities) in China since XX, and it is expected to gradually cover rural residents in the whole country by XX. According to the spirit of the implementation opinions of the Central Committee, the State Council and the provincial government on the establishment of a new rural cooperative medical system, the co-ordination of farmers' serious illness was renamed the new rural cooperative medical system, and the new rural cooperative medical system implemented a financing mechanism combining individual contributions, collective support and government funding. The financing standard is not lower than 30 yuan/person, including county financial subsidy 10 yuan, township financial subsidy 5 yuan, and farmer financing 15 yuan. To sum up, farmers have benefited greatly from the perfect fund-raising and government subsidies, which has established a guarantee for farmers suffering from serious illness, and the highest compensation has reached 200 yuan.
Second, the significance of building a new rural cooperative medical system
After more than 20 years of reform and opening up, great changes have taken place in rural areas of China, and the economy has developed by leaps and bounds. However, economic development has not brought much benefit to farmers on the issue of medical treatment. China's population accounts for 22% of the world, but its medical and health resources only account for 2% of the world. Of the only 2% medical resources, 80% are concentrated in cities. From 1998 to XX, the per capita income of farmers increased by 2.48% annually, but the medical and health expenditure increased by 1 1.48% annually, nearly five times as much as the former. According to relevant media reports, up to now, half of the farmers in rural areas of China have neglected the disease for economic reasons. In economically developed areas like Guangdong, 40.08% of people were ill and didn't see a doctor, and 23.35% of people should be hospitalized instead of hospitalized. In addition, China's social security coverage is still very narrow, which is not enough to solve the problem of farmers? Worried? . In the vast rural areas, the social security system is basically in? Blank area? . Disease is like a sword, hanging over the heads of peasant brothers. Difficult and expensive to see a doctor? It is a common phenomenon in rural areas of China. ? xx？ During this period, the process of economic and social transformation in China will be further intensified. In order to realize this transformation smoothly, the whole society needs to establish a strict and reliable safety net. Therefore, the medical and health problems of farmers have gone far beyond the problem itself. This is not only a question of respecting farmers' minimum survival rights, but also an inevitable requirement of building a fair and just harmonious society. How to solve farmers' difficulty in seeing a doctor? Looking back at history, we have solved this problem, and it was under very difficult conditions. 1993 the world bank's annual development report "investment and health" points out: Until recently, (China) has been an important exception for low-income countries. By the end of 1970s, medical insurance had covered almost all the urban population and 85% of the rural population, which was an unparalleled achievement of low-income developing countries. ? In the early 1980s, the rural population still accounted for 80% of the national population, but the average life expectancy in China has increased from 36 years in the early days of the founding of New China to 68 years. Experts admit that this healthy performance is based on? Put the focus of medical and health work in rural areas? In the general pattern of resource allocation, there are three levels of public health and medical service networks at county and village levels, which are inherent in every rural community. Barefoot doctor? Team and cooperative medical system? Three magic weapons? . Therefore, it is necessary to strengthen rural health work and develop rural cooperative medical care.
Third, historical disadvantage.
Due to the limitation of economic conditions, in rural areas, do you go to the hospital after minor illness, serious illness or serious illness? At present, poverty caused by illness and returning to poverty due to illness are serious, and the number of people in rural areas who need hospitalization reaches 41%; 300 people are poor due to illness in the west? Five million. 70% of poor households in rural areas are poor due to illness. Since 1985, although the income of rural residents has been increasing, the increase rate is obviously smaller than that of urban residents. Excluding the price factor, 1985? During the period of 1993, the average annual real growth rate of rural residents' income was 3. 1%, while the average annual real growth rate of urban residents' income was 4.5% and GDP was 9%. After 1988, the real income growth of rural residents basically stagnated. 1990? From 65438 to 0993, the average annual real growth of rural residents' income was only 1.4%. But at the same time, the medical expenses of farmers have risen sharply. Take Anhui Province as an example. In the first three quarters of XX years, the per capita medical expenditure in rural areas was 42.82 yuan, an increase of 13.6% over the same period of last year. Among them, the per capita medical and health expenditure 19 yuan is close to the per capita annual expenditure of 20.2 yuan last year. 1990, the annual per capita expenditure of pressure therapy was 14.4 1 yuan, the highest in history was 52. 1 1 yuan, 1999 was 5 1.65 yuan, XX years. In the national security system, farmers are excluded from the security system. Rural social security has always been on the edge of China's social security system, and a considerable part of social security content excludes the entire rural population from the security system. The level of rural economic development in China is still very low, and the income level of most rural residents is low and their bearing capacity is weak. Compared with the progress of urban social insurance reform, rural social insurance is only limited to the pilot stage in some rich areas, and family security is still the main body of rural social security. Taking medical insurance as an example, the current medical insurance reform in China is different from that in developed countries. The biggest reason is not universal health insurance, but the reform of medical insurance for urban workers. At present, it is to solve the problem of excessive burden of public medical care and ensure basic medical services. Although the rural cooperative medical system has been widely implemented in rural areas, it has experienced many twists and turns and eventually disintegrated for various reasons.
Fourth, some problems in implementation.
1, low social satisfaction
The most basic and important point of social insurance is that it emphasizes not the equality of individual costs and benefits, but the social satisfaction of insurance benefits. As a kind of social insurance, the satisfaction of farmers who benefit from the new rural cooperative medical system and taxpayers who receive government subsidies plays an important role in its success. The survey found that some farmers did not participate in the new rural cooperative medical system mainly because the level of the new rural cooperative medical system was low, farmers did not understand it, and they were afraid of policy changes, thinking that they were using their own insurance money to compensate others. However, farmers' dissatisfaction with participating in the new rural cooperative medical system is mainly due to the low level of security and the complicated procedures of participation and claim settlement. In addition, unfair policies lead to low social satisfaction of the new rural cooperative medical system.
2. The security level is low.
The new rural cooperative medical system is an economic system of mutual medical care for farmers, which focuses on overall planning of serious diseases and settlement of minor diseases. This definition shows that the new rural cooperative medical system is to help farmers with medical expenses for diseases, but outpatient service, falls and injuries are not covered by this insurance. This provision makes the actual income of farmers not as great as expected.
3. The publicity of the new rural cooperative medical system is not in place.
The existing propaganda mainly introduces the superficial benefits brought by the new rural cooperative medical system to farmers, without establishing farmers' risk awareness and display focus, and without investigating those farmers who do not participate, which makes the propaganda stay in form. Many farmers don't really understand the significance of the new rural cooperative medical system. They only consider their short-term gains and losses. There is no need to spend that money because they are in good health and have a low probability of hospitalization. Some farmers think that, like the previous compulsory education deposit, they were finally cheated by the government, thinking that their insurance money was used to compensate others. The propaganda did not give farmers specific compensation standards, which made them feel cheated when they saw that so many medicines could not be paid.
4. The registration and claim settlement procedures of the new rural cooperative medical system are too complicated.
First of all, the registration procedures for participating in the new rural cooperative medical system are cumbersome. Secondly, the claims procedure of rural cooperative medical care is also very complicated. Urban residents' medical insurance can mortgage a part of medical expenses, pay directly on the card and settle afterwards. Foreign medical insurance allows hospitals, doctors and insurance companies to have direct interests rather than patients. However, some new rural cooperative medical care requires farmers to pay in advance, so if some farmers can't afford to repay the loan, they will go to the cooperative medical reimbursement center to declare and finally go to the credit union to withdraw money. Some villages are far from the reimbursement center and credit cooperatives, and the round-trip fare is more expensive. The cumbersome registration and claim settlement procedures have added a lot of trouble to farmers who have not graduated and reduced their satisfaction.
These are some practical problems that I learned in my work and investigation after reading a lot of relevant materials. Some views on the universal medical security system. During my internship this summer, I was deeply moved by China's emphasis on agriculture, rural areas and farmers. In recent years, the state has gradually exempted agricultural taxes, tuition fees, and a series of policies that benefit the people, such as the new rural cooperative medical system that is now under way. I heard from the nurse in the clinic that many kinds of vaccines are now given to children for free. By the way, I found a shortcoming in my work: the paper that the doctor brought me into the computer is very complicated. I don't think it's necessary to waste a lot of paper to make a bill in quadruplicate now that it has been entered into the computer for saving. A deposit slip will do. Doctors are also very upset about this. After all, we should pay attention to environmental protection while benefiting the people.
Investigation report on new rural cooperative medical insurance II. Investigation time: July 20th, 20xx-August 25th, 20xx.
Two. Investigators: xxx, xx
3. Basic information of Liangcheng Village:
1. Village Status: There are 9 teams in Liangcheng Village, with a total area of 3,200 mu, a total area of 2,200 mu of cultivated land and 2 mu of cultivated land per capita, including rice area 1 100 mu and dry land area100 mu.
2. Population: the population of this village is more than 2,040, and the agricultural population is10.5 million.
3. Economic situation: The economic development level of this village is in the upper-middle level in its offices, all of which are agricultural areas.
4. There are 4 cadres in the village with an annual salary of 8,000 to 1 10,000 yuan. There are clinics, libraries and fixed offices in the village.
Fourth, research background and research content
I also come from a poor family in rural areas, so I care about farmers' patients? Difficult to see a doctor? I have a deep understanding of this problem, so when I become a college student, I pay more attention to this problem and incorporate it into my research topic.
At present, expensive medical treatment is listed as one of the three major livelihood issues in China. Because most farmers can't afford the high medical expenses, they often repeat grades due to illness, delay minor illnesses and wait for death due to serious illness. At the same time, due to their lack of health care knowledge and self-care awareness, they are more likely to be troubled by diseases, leading to poverty and returning to poverty due to illness, and falling into a vicious circle. Lack of medical security has become a serious obstacle to rural economic and social development. In this context, the new rural cooperative medical system was born in June 2002.
The new rural cooperative medical system is a medical assistance system for farmers, which is organized, guided and supported by the government, with farmers participating voluntarily, and financed by individuals, collectives and the government. Since its launch in 2003, China has carried out several pilot projects, and the cooperative medical system is gradually developing and improving. My research content is centered on cooperative medical care. By understanding the implementation of rural cooperative medical care and the villagers' satisfaction with cooperative medical care, I hope to further find problems and make suggestions.
As a measure to benefit the people proposed by the state, the implementation of the new rural cooperative medical system has indeed brought some benefits to farmers, but there have also been many problems in the middle. Therefore, I used my spare time to investigate the cooperative medical system in my village. Through this research activity, I have a certain understanding of the cooperative medical system in our village, and preliminarily summarized the advantages and disadvantages in its implementation, so as to make a general statistics on the overall situation!
Verb (abbreviation of verb) specific work
In the process of investigation, I learned about the cooperative medical care through interviews, and then made a specific understanding through home interviews, summarizing the detailed information about cooperative medical care in our village. There is a designated cooperative medical clinic in our village. In the middle of the village, most villagers see a doctor in the village clinic. Doctors in village clinics have medical licenses, and farmers are guaranteed to see a doctor in village clinics. When talking with doctors, we learned that all the insurance premiums paid by farmers belong to farmers, and each person can enjoy 200 reimbursement after paying the insurance fees. Town hospital inpatients can enjoy 80% reimbursement, and municipal hospital inpatients can enjoy 50% reimbursement. Hospitalized in provincial hospitals can enjoy 40% reimbursement. ?
When talking with farmers, we learned that they were very satisfied with the new cooperative medical system. They said:? Now it is convenient and cheap to see a doctor, and rural doctors have a good service attitude. The villagers are relieved to see a doctor, and now they are not worried about getting seriously ill, and the state can still reimburse them. ? The above is what they mentioned when we talked and did the questionnaire, and the reason is to make everyone think!
This proportion rose from 90% in 2007 to 95% in 2008. The propaganda of cooperative medical care in our village is increasing year by year, and the means of propaganda are also increasing! At the same time, due to some beneficiary families in 2007, they unconsciously played the role of propaganda, and the support of the state is the solid backing for the continuous expansion of this system.
Reimbursement is a big problem of cooperative medical care. At first, most villagers said that they were afraid of trouble and wasted more manpower and material resources, and were unwilling to reimburse them: some villagers also said that the expense account left? Back door? And you have no money or power, you might as well not suffer. Some villagers think that their families are healthy and have no reimbursement, so they are indifferent to this matter; Some villagers explained that they didn't understand the reimbursement ratio and reimbursement process, and they were too embarrassed to ask the family members who had reimbursed them, thinking that this was an invasion of privacy. The villagers who have been reimbursed said that Dr. Qi has a good service attitude and will fill out the daily list for you. If you don't know, they will give you advice. Later, through government departments to increase publicity density, members of the village Committee and businessmen explained the benefits of cooperative medical care to the people, and village cadres helped farmers reimburse them to the town cooperative medical service station. People gradually realized the benefits of cooperative medical care, and changed from unwilling to participate in cooperative medical care to voluntary participation.
We learned from a household with more reimbursement that both husband and wife were sick at the same time, and the treatment left them in debt, which made the already poor family even more stretched. Although the compensation is not enough to fill the family vacancy, on the one hand, it can give the left-behind people some comfort, and it is also an explanation given by the state. It can be seen that poverty caused by illness is still relatively common in rural areas, and there is still a long way to go to fully realize the ultimate goal of cooperative medical care. From the mouth of other villagers, everyone is quite satisfied with the state compensation.
Investigation and analysis of intransitive verbs
Through investigation, it is found that the new rural cooperative medical system has made a good start in Liangcheng village, and the participation rate of 98% can better explain the feasibility of this policy. At the same time, we should also find out the potential problems from reality.
1, and some farmers did not participate in the cooperative medical system, and they still have doubts about it. There are two special families: one is a retired teacher, the state subsidy is better, the daughter is married, and the old man is in good health and doesn't care much about cooperative medical care. The other family didn't apply for a cooperative medical certificate because they thought they didn't have any serious illness and didn't need to see a doctor. This shows that, first, the publicity is in place, but the explanation is not in place. Although everyone knows this policy, the specific implementation process and content are not clear to farmers. Most people still follow the crowd, don't care about details, and are easy to eat dumb losses. Second:? No need? My family is rich, and everyone in the family is in good health, so there is no need to supplement it. Third: the government gives me subsidies, but you let me pay for the competition. I won't do such a loss-making business! Besides, who knows where the money is?
2. The villagers don't know their rights and interests, and they can't keep abreast of policy changes. As mentioned above, one family did not use the cooperative medical book for two years, but did not ask the village cadres to issue a certificate, which led to the same situation as not adding cooperative medical care, which led to the obstruction of policy implementation and the failure to realize its own rights and interests. However, some villagers never bring cooperative medical books when they see a doctor. They either forget to bring them or don't know how to use them.
3. The quality of doctors needs to be improved, and drugs should be clearly marked. On the one hand, the above-mentioned cooperative medical care should be clearly marked to prevent criminals from winning the hearts of the people on drug prices. On the other hand, it is necessary to strengthen the cultivation of doctors' quality and strictly control talents.
4. The reimbursement rate is small and the scope is narrow. Poverty caused by illness often occurs, which is inevitable in rural areas at present. And reimbursement can only be? Monday morning quarterback? Many villagers are puzzled that many high-tech treatment expenses are not reimbursed. Many farmers hope to have a more perfect compensation system, which can really meet the real needs.
5. Farmers are in a passive position in the new rural cooperative medical system. Participation rate? Gaohe? Participate? Low. The total population of Liangcheng Village is 2040, including agricultural residents 1.500. According to statistics, there are 1980 rural residents participating in the cooperative medical system, and the participation rate is over 95%. However, I feel that many farmers are skeptical and wait-and-see about the actual cooperative medical system.
As a project? Policy? The implementation of the new rural cooperative medical system is from top to bottom. Here, of course, the government and hospital management departments are the main operators, and public medical institutions at the flag and township levels are also active, while farmers are completely passive. Farmers who have been publicized, mobilized and asked to be passive do not seem to know that they should be the owners and beneficiaries of cooperative medical care. Although the relevant departments have achieved a high level through mobilization and encouragement? Participation rate? But what about farmers? Participate? Not high, that is, lack of inner recognition, trust and confidence, and low enthusiasm.
Seven, my suggestion
After investigation, I summarized the problems I found:
First, while increasing publicity, we can explain the rules and regulations of cooperative medical care to the villagers in a deeper and more detailed way, so that farmers can know fairly well. When necessary, training courses can be held regularly, and experienced personnel can be invited to explain relevant information, or beneficiaries can be invited to dedicate themselves to preaching.
Secondly, farmers are the main force of cooperative medical care, and only when they are really mobilized can cooperative medical care be regarded as the final success.
Third, the quality of grassroots cadres and medical personnel needs to be improved. As the saying goes, a dead mouse spoils a pot of porridge. If one person's mistake or negligence affects the implementation of the whole policy, it is not worth it. Talent is the key, so to effectively control talent, the government should be extremely strict in selecting talents to prevent similar incidents from happening at the source.
Fourth, mark the price of the winning number, and announce some drug prices every day, so that farmers can see and know the specific situation of drug prices and truly know what they are. And strengthen supervision, if possible, let farmers participate in supervision, in case it is for the people and used for the people.
Eight, the end
Through this survey, I took cooperative medical care as the main starting point and got a deeper understanding of some basic situations in rural areas. In this vast land of China, Liangcheng Village may not be a typical rural area, but through years of work in the village branch cadres, I personally feel that Liangcheng village cadres and the masses are trying to find a way out, try to catch up with the times and try to become a demonstration point of new countryside.
The implementation of the new rural cooperative medical system conforms to the vital interests of farmers, is conducive to the coordinated development of urban and rural areas in China, and is conducive to narrowing the gap between the rich and the poor in urban and rural areas. It was not smooth in the initial stage of implementation, and there must be many practical problems, so we need to accumulate experience in the promotion process. I believe that with the continuous efforts of the party and people, it will become a successful model of rural cooperative medical care reform in China and contribute to the great cause of building a new socialist countryside.
Investigation report on new rural cooperative medical insurance. The new rural cooperative medical system is a huge systematic project implemented by the state on the basis of building a new socialist countryside to speed up the establishment of rural medical security system, improve farmers' health level and better promote the coordinated development of urban and rural society and economy. In order to ensure the smooth development of this work, under the unified leadership and deployment of the Banner Committee and the Banner Government, xx has carefully organized and vigorously implemented it, and with the active participation of the broad masses of rural people, initially established a new rural cooperative medical system in our town, including serious illness planning, medical assistance and rural medical and health services. In order to effectively consolidate this system and further explore the establishment of a long-term mechanism for healthy and sustainable development, the research group of xx CPPCC has carried out research activities on the development and operation of the new rural cooperative medical system. The investigation is hereby notified as follows:
First, xx new rural cooperative medical care status and effectiveness
Xx is a big town formed by the merger of the original xx three towns after the township institutional reform in 20xx, with * * * village (neighborhood) committees and a permanent population of xx people. Among them, the number of agricultural households is xx, the population is xx, and the per capita net income of farmers is xx yuan. There are 3 township hospitals, xx village clinics and 74 rural doctors. By the end of April this year, xx people had participated in the whole town, and the participation rate reached 82. 1%.
Major achievements:
(1) Strengthen leadership. The town party Committee and government proceed from reality? Theory of Three Represents theory? Based on the important thought and strategy of coordinating urban and rural development, according to the guidance of the flag government and the local conditions, the implementation plan and related systems of the new rural cooperative medical system were formulated, and a leading group with the mayor as the team leader, the mayor in charge as the deputy team leader and the heads of relevant departments was established, and leading groups were also established in each village (neighborhood). In order to ensure the smooth development of the work, the town government will incorporate the implementation progress and effectiveness into the target management responsibility system of each village (neighborhood) and cash rewards and punishments at the end of the year.
(2) Careful implementation. 20xx On February 23rd, the town government held a mobilization meeting for the rural cooperative medical system, widely publicized the advantages of the new rural cooperative medical system, and actively guided and mobilized the broad masses of rural people to participate. The town dispatched 58 cadres to 29 villages to carry out door-to-door publicity and mobilization with village cadres. By posting slogans, distributing brochures and other publicity forms, the enthusiasm of farmers to participate in the project has been greatly mobilized, ensuring the smooth completion of fund-raising work and the smooth implementation of the system.
(3) Standardize management. In order to coordinate the cost-effective work, the town government also set up the new rural cooperative medical system office, and the members of the village (neighborhood) Committee set up liaison officers, which provided organizational guarantee for the standardized management of rural cooperative medical system. Constantly improve the rules and regulations of the new rural cooperative medical system, standardize the management of designated hospitals, simplify the audit procedures of final reports, implement the service commitment system, and strive to provide quality services to the masses. At the same time, strengthen the management of funds, set up a special account for revenue and expenditure in the financial office, strictly examine it, put an end to unreasonable and illegal compensation expenses, report it regularly, and accept the supervision of the higher-level finance, auditing departments and the masses.
(four), the main changes in the new cooperative medical system. According to the survey, the first is to reduce the burden of medical treatment for farmers and solve the problem of farmers returning to poverty due to illness to a certain extent. By the end of June of 20xx, xx*** will compensate the sick farmers for medical expenses in RMB, including outpatient expenses in RMB; Hospital supplement, pay yuan; Some people received more than 4,000 yuan in compensation, and the highest was xXX in XX village, with medical expenses of RMB and compensation of RMB. The second is to improve the delivery rate of rural women in hospital. According to the survey, at present, more than all pregnant women go to medical delivery to ensure the safety of mother and baby. Third, farmers' awareness of self-care has increased. In the past, many farmers often? Dragging a serious illness, suffering from a minor illness, going to the hospital until death? Seeing a doctor is often the last resort. Fourth, it has promoted the improvement of the service level of rural medical institutions. At present, three designated hospitals in xx can actively improve the software and hardware environment, strengthen system construction, publicize drug prices, strengthen medical management, and do everything possible to improve hospital reception level and capacity. By improving the service and reducing the cost, the number of outpatients and inpatients has increased greatly, which has improved the economic and social benefits of the hospital.
Second, the new cooperative medical system is facing new problems
The new rural cooperative medical system is a long-term and arduous social security project. At the beginning of its implementation, there are still many difficulties and problems, mainly in six aspects:
(A) the propaganda and guidance work is not deep enough, and the enthusiasm of farmers to participate in insurance needs to be improved. In the process of implementation, on the one hand, due to the tight time and heavy tasks, the policy propaganda and guidance work is not deep enough, on the other hand, farmers lack experience in the new rural cooperative medical system, have a vague understanding of the old system, and have insufficient confidence in long-term implementation, resulting in some farmers' low enthusiasm for participating in insurance and less voluntary participation.
(2) The audit and settlement process is still complicated, and the convenience service needs to be further optimized. Because some farmers are far away from designated medical points, less medical expenses and round-trip fares are not worth the loss.
(3) There are still some unreasonable policies and systems. Mainly manifested in the high reimbursement threshold, low reimbursement ratio, narrow scope of reimbursement drugs and too many restrictions. Lack of supervision of designated hospitals. It is difficult for township governments to manage hospitals well, so they can only rely on the supervision of drug supervision departments, so the government is in an embarrassing situation. On the one hand, the government actively does mass work to increase the participation rate; On the other hand, the high price of drugs in hospitals and the large price difference between farmers and pharmacies affect farmers' enthusiasm for participating in insurance.
(5) The facilities of township medical institutions are obsolete. Due to the depression of township hospitals in recent years, the state's investment in hospitals is seriously insufficient, resulting in outdated equipment and a serious shortage of medical staff, and many diseases can not be treated by technical means. Farmers reported that they should look for hospitals at or above the county level to see a doctor.
(6) The expectations of farmers are too high. Farmers think that only with the cooperative medical certificate, which level of hospital to go to should be their own decision, and they don't want to be bound, especially when they see that they spend more money and have less reimbursement after hospitalization.
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