新型农村合作医疗制度自愿保险的困境与出路

面对新型农村合作医疗在实践中普遍存在的逆向选择问题,政府补贴的增加虽能提高农民的参合意愿,但它仍是治标不治本。如果不能很好地解决这个问题,新型农村合作医疗不能可持续发展,要么会因保障水平不够而夭折,要么就会出现财政赤字而难以为续。在短期内,可以在坚持自愿原则下、在自愿性的框架中,通过兼顾门诊补偿、对一年内没有享受住院治疗服务或门诊服务的参合者提供相应的促进健康和预防疾病服务、调整筹资顺序等手段扩大受益面来寻求可持续发展之路;最终通过引入强制性从根本上解决逆向选择的困境。

The Predicament about the Voluntary Insurance of the New Rural Cooperative Medical System

As a voluntary public medical insurance,one of the serious challenges which the new rural cooperative medical system facing is how to deal with the adverse selection problems which exist prevalently in the voluntary medical insurance.In the new rural cooperative medical system,if it can not be solved well,then the new rural cooperative medical system can not develop continuously,which will result failure caused by the level of safeguard insufficient.Or because of the financial deficit made it can not go on.We may persist in voluntary under the new rural cooperative medical system,through pay attention to compensation of outpatient service;providing correspondence service of promoting health and preventing disease,and adjusting finance sequence to those members who not enjoy the hospital service or outpatient service care in one year.In this way,it expands profit proportion in order to seeking the way of developing continuously.Finally,through compulsion solve the predicament of adverse selection fundamentally.