【作者】 陈谦；

【导师】 李金龙；

【作者基本信息】 湖南大学 ， 公共管理， 2012， 硕士

【摘要】 健康是人类的基本权利。人口健康的改善可以提高劳动生产率，增加劳动力供给，促进经济持续增长。因此，农民的健康是发展农村经济、建设社会主义新农村的基础。人民共和国成立后，我国就为农民建立起了医疗保障政策——农村合作医疗政策，初步形成了以集体经济为依托的农村初级医疗卫生保健网，使农村医疗卫生事业得到了发展，有效地为农民的身心健康提供了医疗保障。但在改革开放之后，随着集体经济的解体，合作医疗政策很快走向衰微，致使中国农民在没有任何医疗保障的情况下生存了近30年，医疗费用完全靠个人支付，农民负担较重，因而出现了部分农民看病难的问题。特别是遇到大病，农村较贫困人口很容易陷入因病致贫、因病返贫的现象。由于多数农村地区的经济发展水平比较低，还不具备把农民医疗保障纳入社会医疗保险的条件，政府和集体也没有能力把农民的医疗保障包起来，目前只能够通过农民互助共济，加强政府的扶持力度，建立新型农村合作医疗政策的方式来解决。所以，政府从2003年开始在部分省区进行建立新型农村合作医疗政策试点工作，这一政策的出台为提高农民健康保障水平，减轻医疗负担，解决因病致贫、因病返贫的问题开启了希望之门。本文对湖南省常德市鼎城区新型农村合作医疗政策在贯彻执行中发现的问题进行了较为系统而深入地分析研究。本文首先介绍了选题的背景与意义、国内外文献综述以及研究方法与研究内容。其次，本文从研究新型农村合作医疗政策执行问题的理论基础入手，对新型农村合作医疗政策的内涵、特征以及相关的理论支撑都进行较详细地阐释，并论述了强化新型农村合作医疗政策执行的必要性。再者是结合相关实际数据及相关现有资料对常德市鼎城区新型农村合作医疗政策的执行情况进行了调查研究，肯定了自试点以来常德市鼎城区在执行新型农村合作医疗政策中取得的初步绩效，特别是对政策执行过程中发现的问题及其产生的原因进行了较为深层次的剖析。然后在理论分析和实践经验的基础上提出了进一步强化新型农村合作医疗政策执行的对策建议。论文在这个方面的研究将为湖南省和全国一些情况相近的地州市在执行该项政策中提供一定的借鉴，也有助于推动政策研究者对新型农村合作医疗政策执行问题作出更深入地研究。更多还原

【Abstract】 Health is a basic human right. Population health improvement can improve laborproductivity, increase labor supply and promote sustained economic growth. Sofarmers’ health is the base of developing the rural economy and the construction ofsocialist new countryside. After liberation, our country has set up the medical securitysystem (rural cooperative medical system) for peasants, initially forming ruralprimary health care network relying on the collective economy, making the ruralmedical and health undertakings developed, effectively providing the medical securityfor farmers’ health. But after the reform and opening, with the disintegration of thecollective economy, cooperative medical system declined soon, medical treatmentcharge completely paid by individual, forming relatively heavy burden on farmers,thus appearing the problem of getting difficulty of medical service. Especially for therural poor people with serious illness, it is very easy for them to fall intofinancial-difficulty. Because the economic development level of most rural areas islow, the rural medical security still cannot be orbited into the social medical insurancesystem. The governments also do not have the ability of shouldering the farmers’medical service security. Now through the farmers’ help of each other in all aid andstrengthening of government’ support, establishing the new rural cooperative medicalsystem to solve the problem. So, the government began to set up the new ruralcooperative medical system pilot work in part of provinces in2003. This policyopened the door of hope to improve farmers’ health security level, reduce the medicalburden and solve financial-difficulty due to illness.In this paper, it conducted a systematic and in-depth analysis and research on theproblems found in carrying out new rural cooperative medical system in theDingcheng District of Changde City of Hunan province. This thesis first introducedthe background, meaning of the topic selection and the domestic and foreign literaturereview and research methods and research content. Secondly, from theoretical basis ofthe execution of the new rural cooperative medical system, this article gave a detailedinterpretation on the connotation, characteristics and relevant theory support of thesystem. And it discussed the necessity of execution of strengthening the new ruralcooperative medical system. Moreover, it investigated the implementation of the newrural medical cooperative system in Dingcheng District of Changde City combining with the relative actual data and relevant existing material. It affirmed the preliminaryachievement in carrying out the system in Dingcheng District of Changde City.Especially for the problems found in the execution of the system and the reasons, thepaper gave a relatively deep analysis. And then, on the basis of theoretical analysisand practical experience, it put forward countermeasures and suggestions for furtherstrengthening execution of the system. For some similar situation indexs in Hunanprovince or even in China, the research provided certain reference in the execution ofthe system. Also it promoted policy researchers to make further research on thesystem execution.更多还原