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作为社会保障制度的重要组成部分,农村医疗保障制度既是整个农村地区农民健康的基本保障,也是我国统筹城乡社会、经济及医疗卫生事业持续、稳定、和谐发展的客观需要。目前,我国农村的主要医疗制度为近些年顺势推行的新型农村合作医疗制度,但由于其自身发展所具有的固有缺陷,从而使其仍会陷入保险市场中常见的“逆向选择”悖论中,不利于新农合在一定时期内普遍覆盖这一目标愿景的实现。而现实中所采取的通过将“自愿性原则”改为“强制性原则”的处理方式,短期内无法实现“人人参与”的目标,更有悖于“人人有保障”的发展战略。本文基于政府行为优化视角,提出建立多层次、多元化的农村医疗保障体系的治理思路,并针对不同的目标群体,提出政府行为的宏观策略和微观策略。
As an important part of the social security system, the rural medical security system is not only the basic guarantee for the health of peasants in rural areas as a whole, but also the objective need of our country for the sustainable, stable and harmonious development of the social, economic and medical and health undertakings in urban and rural areas. At present, the primary medical treatment system in rural areas in our country is the new-type rural cooperative medical system that has been vigorously implemented in recent years. However, due to the inherent defects in its own development, it will still fall into the common “adverse selection” paradox in the insurance market On the theory, it is not conducive to the NCAR in a certain period of time to achieve the common vision of this goal. However, in reality, the goal of “everyone involved” can not be achieved in the short term by changing the “voluntary principle” to the “mandatory principle”, which is even more contrary to the principle of “everyone Guaranteed ”development strategy. Based on the optimization of government behavior, this paper puts forward the idea of establishing a multi-level and diversified rural medical security system and puts forward the macro-strategy and micro-strategy of government action for different target groups.