Institute of Military Health Management, Second Military Medical University, Shanghai, China.
Health Aff (Millwood). 2012 May;31(5):1058-64. doi: 10.1377/hlthaff.2009.0808.
One of the components in China's massive health reform effort is the New Cooperative Medical Scheme, which is intended to provide affordable health insurance, especially to the rural poor. This program offers three options with different benefits and costs to county health officials, who select one of the options to make available to local residents. Data were obtained from the New Cooperative Medical Scheme survey conducted by the Chinese Ministry of Health and the World Bank in 2005, which covered more than 47,000 people living in twenty-seven counties, to determine participation levels, identify which option was most attractive, and characterize the impact that each option had on care and costs. Our study found that those participants with the most limited coverage might have delayed seeking care, while the broadest coverage--the "Cadillac option"--was the most popular. Yet if this generous package were to be broadly offered, health costs would become unsustainable. Therefore, the Chinese government must consider which costs to cover for people in economically depressed rural areas.
中国医疗改革的一个重要组成部分是新型农村合作医疗制度，旨在为农民特别是农村贫困人口提供负担得起的医疗保险。该制度为县级卫生官员提供了三种不同的保障方案，各有不同的保障范围和费用，卫生官员选择其中之一供当地居民使用。我们的数据来源于中国卫生部和世界银行在 2005 年进行的“新型农村合作医疗制度”调查，覆盖了全国 27 个县的 47000 多人，目的是确定参合率，找出最受欢迎的保障方案，并分析各方案对医疗服务利用和费用的影响。我们的研究发现，保障范围最小的参合者可能会延迟就医，而保障范围最广的方案——“凯迪拉克方案”则最受欢迎。然而，如果要广泛推行这一慷慨的保障方案，将会导致医疗费用不可持续。因此，中国政府必须考虑为经济欠发达的农村地区的民众提供哪些费用的保障。
