外文翻譯--關于中國成都基本醫(yī)療保險城鄉(xiāng)統(tǒng)籌制度改革的研究（原文）

1、2010 International Conference on Public Administration (ICPA 6th ) Edited by ZHU Xiao-ning and ZHAO Shu-rong ·544· ICPA Research on the Reform of Basic Medical Insurance System of Urban and Rural Coordinative

2、 Development in Chengdu, China 1. GUO Hong-ling 2. LI Yong-sheng 1. School of Public Administration, Southwest Jiaotong University, Chengdu, P.R. China, 610031 2. The Hospital of Southwest Jiaotong University, Chengdu,

3、 P.R. China, 610031 Abstract Management system of binary segmentation between urban and rural in China in the past, led to unbalanced development and unfair treatment between urban and rural areas in the supply of bas

4、ic medical care services, which badly has affected the social harmony. In recent years, Chengdu city government plays a leading role in the process of building basic medical insurance system. Aiming at the problem of m

5、edical and public health system, they actively explore to establish the unification medical security system covering all people, to integrate incompatible management organizations, to achieve unified basic medical insu

6、rance system between the urban and the rural. This paper summarizes the exploration of integration basic medical insurance system between urban and rural in Chengdu on the basis of the survey to some counties in Chengd

7、u, and hope to provide a reference to developing countries in realizing equalization of basic medical insurance. Key words Basic medical insurance system, Urban and Rural coordinative development, Reform, Chengdu 1

8、Introduction China carried out “prevention first” medical insurance system in 1950s.Though the system was praised as “Chinese model” with “the least investment, maximum health return” by the World Bank, （ World Bank,

9、1993[1]） but with increasing population and society development, the model with “the government took on everything” showed many problems such as different policies between city and country, fewer crowds benefiting from

10、 medical insurance, unfair medical resource allocation between cities and countries. In 1985, the Chinese government tried to marketize medical treatment and public health in order to relieve financial burden and enlar

11、ge medical insurance benefited people. But research showed the reform was mainly unsuccessful (Development Research Center of the China State Council, 2005[2]). How to reform medical insurance system? This problem beca

12、me an academic concern in China in recent years. Many scholars researched this problem from different point of views. Some analyzed the problems of Chinese medical insurance system and the countermeasures. (Jin Qi-lin,

13、 Zhu Qian, 2010[3]; Qu Nai-qiang, Yuan Qing-hui, Jing Xue-yan 2009[4]); some introduced overseas medical insurance system(Hou li-ping,2006[5]; Yue Song-dong, 2005[6]); others investigated the residents medical and hea

14、lthy service needs (Zhou Li-ye, Ma Fei, Qu Cheng-yi,2010[7]) and degree of satisfaction (Liang Yao-yuan, Ni Jian, Huang Zhi-bi,2010[8]). But current studies hardly touch upon the concrete practice from local government

15、. In fact, after the China State Council issued “Guidance about medical health system reform in city and town” in 2000, local government had some new practice and got some preliminary results. In 2007, the China State

16、Council established 6 urban and rural coordinated development experimental sites in order to solve the equalization of urban and rural public service. Fortunately, Chengdu is one of them. This paper attempts to summari

17、ze Chengdu’s reform exploration in the coordination of urban and rural medical health system and hope to provide a reference to developing countries in realizing equalization of basic medical insurance. . 2 The brief r

18、eview of China health system reform after reform and opening After reform and open, China health system reform may be divided into three stages (Wang He-jiang, Chen Guo-ying, 2010 [9]): The first stage is from1985 to

19、1994. In 1985, the China State Council endorsed “Ministry of Health’s report about some policy problem of health care reform”, put authority and yield benefit to medical institutions and encouraged them earning and sel

20、f-development. In 1988, the Ministry of Health issued “the suggestion about some problem of enlarging medical and health services”, put 2010 International Conference on Public Administration (ICPA 6th ) Edited by ZHU Xi

21、ao-ning and ZHAO Shu-rong ·546· ICPA 4 Exploration and experiment in Chengdu Since 2006, Chengdu city government has explored all ways to achieve basic medial insurance equalization. 4.1 Construction of “cr

22、iss-cross” medical insurance system. “Criss-cross” medical insurance system aims to achieve basic medial insurance and health service covering all groups. Longitudinally, the government has made various policies includ

23、ing basic medical insurance for urban staff, medical insurance for landless farmers, comprehends “criss-cross” social insurance for migrant workers, new rural cooperative medical care insurance, basic medical insurance

24、 of urban residents and basic medical insurance of municipal universities’ students. Horizontally, it has established medical insurance systems of the adaptation of the main layer, basic layer and supplementary layer.

25、 The basic medical insurance is applicable to the main layer. The supplementary clinical medical insurance and hospitalization supplementary medical insurance and various commercial health insurance can meet the masses

26、’ diverse needs. For disadvantaged groups, the government offers medical aid of clinics and hospitalization, one-time temporary aid and rural medical aid. By “criss-cross” medical insurance system, Chengdu has become t

27、he nation’s leading in achieving the basic medical insurance system covering urban and rural areas. 4.2 Unification of medical insurance system between the urban and the rural Chengdu has realized the unity of the ba

28、sic medical insurance system with three steps since 2001. Firstly, during 2001 and 2007, according to different groups and different health care needs, Chengdu has established various basic medical insurance systems co

29、vering all types of groups. Secondly, in 2008, Chengdu has integrated and improved various systems of the medical insurance system of the urban staff and both urban and rural residents. Thirdly, in 2009, Chengdu has in

30、tegrated new rural cooperative medical care insurance, basic medical insurance of urban residents and basic medical insurance of municipal universities into integrative medical insurance system. Chengdu city governmen

31、t has also issued “Interim Measures on Basic Medical Insurance of Urban and Rural Residents in Chengdu” and has unified the medical insurance system of the urban staff and both urban and rural residents to cover all gr

32、oups. 4.3 Equalization of health care treatment between urban and rural areas. Chengdu City government has established medical insurance system which consists of basic medical insurance for urban staff, basic medical

33、insurance for rural residents and comprehensive social insurance for migrant workers on the principle of “same standard of financing, subsidy and insured benefits between rural and urban areas”. And the system has cove

34、red all groups. The group who can not afford insurance bill will receive subsidy from the government. At the same time, the government has increased fund input to rural areas and urban communities. With fund from the

35、government, 224 public hospitals and more than 2100 health stations in countryside have been reconstructured with standardized basic medical facilities, standardized program of procurement and distribution of medicame

36、nts, which enable all villagers have access to medical and health services. In addition, 125 health service centers in urban communities have also reconstructured with standardized basic medical equipment, thus all the

37、 residents can receive medical treatment within 15 minutes. And the government has provided periodically free medical training to all medical personnel in rural areas and urban communities in order to improve their med

38、ical technology. 4.4 Integration of management organizations and system Separate management organizations in urban and rural areas have been integrated into the health insurance authority, which manages basic medical

39、 insurance and industrial injury insurance, maternity insurance in 2007. Health insurance authority has been set up in each district .And the fund of basic medical insurance is in the charge of municipal management age

40、ncy, which effectively solve the problems such as multiple management departments, dispersed funds and weak anti-risk ability. Urban and rural medical assistance system has been established. Medical aid fund has been f

41、ounded. Thus timely medical services have been accessible to patients with major diseases. In addition, the government has established comprehensive information network of health and medical insurance services includi