澳门大学硕士学位论文 Abstract China is a big agro-country in the world from of old, and farmers of China have an important effect on the stage of China history. Since 1930s, the government of China has a great attention to rural area and the security of farmers. Rural Cooperative Medical Systems (RCMS) in China began its development. There are six periods during RCMS development and it's New Cooperative Medical System (NCMS) now. Different period has different financing mechanism which depends on the temporal historical circumstance. The paper gives some advices to NCMS according to research those systems. There are also some problems during NCMS development, Such as adverse selection which because of "voluntary rule", the problem of transfer payment, the trading off between equity and efficiency and so on. We can resolve those questions: the adverse selection can be reduced by the drumbeating, and enhancing the joint between the NCMS and urban social medical insurance also can raise the joined rate of high quality clients. To reduce the unfair between the East area and West area in China, we can take the transfer payment and give favorable conditions to the West areas. Comparing the National Health Insurance (NHІ, Taiwan), NCMS require laws to insure actualizing. At last, for the total financing amount, the paper gives a design. The paper research methodologies include literature review, history retrospective research, case study, comparative study and quantitative study. To fill up the blank and accelerate NCMS development, the paper is comparing different systems and calculating the amount. There're two innovations of the paper: description with historical circumstance and new financing model design. But because of the limitation of writer and time, the insufficiency of the paper is also clearly, requiring continuous study to complete it. Key words: Financing, Rural Cooperative Medical System (RCMS), New Cooperative Medical System (NCMS). itf

澳门大学硕士学位论文 摘要 中国自古以来就是一个以农为本的大国,农民在中国的历史舞台上起到了举 足轻重的影响。自20世纪30年代以来,中国政府一直关注农民医疗保障问题, 中国的农村合作医疗体系也从无到有,经历六个阶段,目前处于新型农村合作医 疗(简称新农合)时期。不同时期有着不同的筹资模式,这些筹资模式有着不同 的历史背景,研究这些模式可以对当前的新农合提出改进意见。目前新农合体系 筹资还面对着许多问题,“自愿”导致的逆向选择、转移支付力度不足和公平与 效率的取舍问题仍在存在,这些问题目前的解决的方法也在讨论之中,通过加大 宣传力度,加强和城市保障系统接轨的措施来吸引优质客户参合以克服逆向选 择;通过转移支付手段和政策倾斜来缓解东西部地区在卫生服务领域上的不公 平;通过立法保证新农合实施。最后针对新农合提出后一直没有具体筹资具体数 额上的核算,通过文章里的设计可以得出一个概念上的筹资总量。本文采用了文 献分析,历史回顾,比较案例研究和定量研究的方法,对比历史并且核算数据, 旨在填补学术空白,并推动新农合的推广。创新点在于结合历史描述筹资模式, 采用全新的筹资设计。但是限于作者本身水平和时间的问题,仍有很多问题存在, 期待在后续研究中不断补足。 关键词:筹资,农村合作医疗体系,新型农村合作医疗体系。 11