Foreign Rural Medical Insurance

China's rural medical insurance is rural cooperative medical care. It is organized, guided and supported by the government, with farmers voluntarily participating and multi-party financing by individuals, collectives and the government. A rural medical mutual aid financial system that focuses on coordinating serious illnesses. Funds are raised through individual contributions, collective support and government funding. This model is based on China's population structure and national strength. There are also rural medical insurances abroad, which mainly include the following centralized models:

Free medical insurance

Free medical insurance model, also known as The national medical and universal medical security model means that medical security funds mainly come from taxation. The government, through budget allocation, allocates the medical security funds formed from taxation to relevant departments or directly to public hospitals in a planned manner. When medical security recipients see a doctor, A system that basically requires no payment. Countries that implement a free medical security model basically have hospitals run by the state to provide medical services. The salaries of medical staff working in public hospitals are allocated directly by the state. The publicly funded medical care once implemented in China, as well as the welfare universal medical security system implemented by developed countries such as the United Kingdom, Canada, Sweden, Ireland, and Denmark, and developing countries such as Malaysia and Vietnam, all fall into this category. Except for China's publicly funded medical care system, which is limited to urban employees, countries that implement free medical security systems usually cover all citizens, and of course all rural residents.

Malaysia

In Malaysia, public health expenditures such as health and epidemic prevention, maternal and child care, etc. are all borne by the state. Medical care is subject to low charges. One outpatient visit including medicines only costs 1 ringgit (Malaysian currency, 1 US dollar is equivalent to 2.47 ringgits), and one day of hospitalization including treatment, medication and meals costs only 3 ringgits.

All medical services provided by the government in rural areas are free of charge. Inpatients pay a small meal fee. Farmers in poor areas and areas with poor medical conditions can get exemptions, but the medical technology is average and the types of drugs are limited. . The main problems:

First, medical and health expenses are fully covered by national funds, which imposes a heavy financial burden.

Second, the level of medical services provided is relatively low, and it is still difficult to see a doctor.

Commercial medical insurance

Commercial medical insurance is a medical insurance model that treats medical insurance as a special commodity and operates freely according to market rules. In the medical insurance market, the seller refers to a profit-making or non-profit private medical insurance company or a private medical insurance company; the buyer can be an enterprise, a social group, the government or an individual. The funds for commercial medical insurance mainly come from the insurance premiums paid by individual insured persons and their employers. Generally speaking, the government does not contribute funds or subsidize it.

United States

The United States is a typical representative of the implementation of the commercial medical insurance model. Although the U.S. government has established social medical insurance programs such as the medical care system, the medical assistance system, and free medical care for ethnic minorities, they do not occupy a major position in the entire medical insurance system, and the scope of their coverage is very limited. In the United States, more than 80% of state civil servants, private enterprise employees, and farmers are not protected by social insurance, but participate in the commercial insurance system. There are more than 1,800 commercial medical insurance organizations across the country.

Commercial medical insurance in the United States is divided into two types: non-profit and for-profit. The former can enjoy preferential tax treatment, while the latter does not enjoy related treatment.

The characteristic of the American commercial medical insurance model is that medical insurance is mainly operated and managed by the market, and the government is only responsible for medical insurance for the elderly and the poor. Insurance expenses are mainly borne by individuals and enterprises, and the government basically does not bear it. The outstanding problem of this model is that social equity is poor, and a considerable number of low-income small business employees, self-employed workers and farmer families do not have access to medical insurance.

Community cooperative medical security

The community cooperative medical security model refers to relying on the strength of the community and in accordance with the principle of "risk-taking, mutual assistance and economic benefits". A comprehensive basic medical care measure that establishes a centralized medical fund through crowdfunding within a certain scope (the government usually also provides certain subsidies), and adopts a prepayment method to pay for medical, preventive, health care and other service costs for insured persons and their families. China’s traditional rural cooperative medical system and Thailand’s medical insurance card system are representatives of the community cooperative medical security model.

Thailand

Thai farmers mainly participate in community cooperative medical insurance by purchasing health cards. Thailand's health card system was implemented in rural areas in June 1983. It is based on family (household) participation. Each household has one card. Those with more than 5 people purchase another card. Children over 50 years old and under 12 years old enjoy free medical care. Each card costs 500 baht at the family's own expense (1 baht is approximately US$0.0264), and the government subsidizes 500 baht. In order to promote the issuance of health cards, the government stipulates that subsidies will only be provided if more than 35% of households in the village participate. The funds raised by the health card are coordinated and managed by the provincial management committee (the country is divided into 76 provinces), 90% is used to pay for medical care expenses, and 10% is used to pay administrative expenses. Health cards can be used for medical care, maternal and child health care and immunization programs.

The community cooperative medical system combines the raising of medical funds in a region, the sharing mechanism of economic losses caused by illness and the provision of medical care services, and can provide better basic medical care in grassroots units. and preventive health care to effectively protect the health of grassroots farmers. Its limitations are limited funds, a small number of people covered, and poor ability to resist the risk of serious diseases.

Social medical insurance

Social medical insurance refers to the medical services and economic support that are organized by the state in the form of social insurance to farmers due to illness, injury or childbirth. The compensation system has the characteristics of compulsory, mutual aid, welfare and social nature of social insurance.

Social medical insurance funds come from three sources: the state, collectives and individuals. Usually individuals only need to bear a small part of the costs.

South Korea

South Korea passed its first "Medical Insurance Law" in 1963. Due to the difficult social and economic conditions in South Korea at that time, the national medical insurance plan was voluntary insurance, and the number of insured people was very small. few. In the late 1970s, South Korea's economy was developing rapidly, and the country decided to implement compulsory medical insurance. In 1988, it was expanded to rural areas across the country, covering 90% of the rural population. The government provides medical relief to the remaining 10% of farmers below the poverty line.

Fund raising for rural medical insurance in South Korea: farmer families pay 50% and the government pays 50%. There are three ways to share the cost of medical services: First, deductible payment. Patients pay $4 per visit. The second is the proportion of out-of-pocket expenses. Patients pay 30% out-of-pocket for out-patient care in clinics and 50% out-of-pocket for out-patient care at hospitals. The third is hospitalization cap. The insurance department will pay for up to 180 days of hospitalization expenses per year, and the rest will be borne by the patient themselves. The law stipulates that medical services implement a step-by-step referral system.

Main existing problems:

First, the problem of uneven distribution of health resources is becoming increasingly serious, with excess in cities and insufficient in rural areas.

Second, the level of primary medical institutions is low and people are unwilling to go to see a doctor. The utilization rate of primary medical institutions is only 25%.

The third is the difficulty in financing medical insurance for farmers (young people go to cities to make a living, while the elderly and children stay in rural areas, resulting in high morbidity and high medical expenses).

Fourth, only low-quality free medical services are provided to 10% of poor farmers.