中国农村合作医疗微观要素机制的演进和变迁  

The Evolution and Change of the Micro-element Mechanism of China’s Rural Cooperative Medical System

作　　者：任雪娇[1] 孙淑云[2] REN Xue-jiao;SUN Shu-yun(School of Politics and Public Management,Shanxi University,Taiyuan 030006,China)

机构地区：[1]山西大学政治与公共管理学院,山西太原030006 [2]山西大学法学院,山西太原030006

出　　处：《医学与哲学》2020年第9期67-73,共7页Medicine and Philosophy

基　　金：2019年教育部人文社会科学研究规划基金项目(19YJA820037);2019年山西省“1331工程”重点创新团队建设计划项目。

摘　　要：作为中国特色的农民医疗保障制度,中国农村合作医疗70年制度变迁,是适应中国宏观体制机制变迁的结果,是城乡二元经济社会政治体制向一元化体制机制战略转型的"活化石"。合作医疗的参保主体、基金筹集、管理经办和待遇支付等微观要素机制,分别与经济、社会和政治体制的变革耦合与适应,从要素制度的"渐进性"变革起始,牵一发而动全身,带动合作医疗实现整体性制度创新和变迁,构成了合作医疗制度演进和变迁的微观图景,并依此形成了中国农村合作医疗制度变迁的特色逻辑,为解决当下新农合与城居保制度"整而不合"的实践难题提供借鉴路径。As a rural medical security system with Chinese characteristics,the 70-year institutional change of China’s rural cooperative medical system is the result of adapting to the change of macro-institutional mechanism and the "living fossil" of the strategic transformation from urban-rural dual economic,social and political system to unified institutional mechanism.The insured subject,fund raising,management and payment,and other micro-factor mechanisms of China’s Rural Cooperative Medical System,which are respectively coupled with and adapted to the changes of economic,social and political systems.The "gradual" reform of the original system and its far-reaching impact drives the overall innovation and change of the cooperative medical system,constitutes the micro-vision of the evolution and change of the rural cooperative medical system in China.Accordingly,it forms the characteristic logic of the change of the rural cooperative medical system in China,which provides a reference path for solving the "integrated but incompatible" problems in the current new rural cooperative medical care system.

关 键 词：中国农村合作医疗制度 微观要素机制 演进变迁 逻辑理路 

分 类 号：R-05[医药卫生]