What is New in the "New Rural Co-operative Medical System"? An Assessment in One Kazak County of the Xinjiang Uyghur Autonomous Region - PubMed (original) (raw)

What is New in the "New Rural Co-operative Medical System"? An Assessment in One Kazak County of the Xinjiang Uyghur Autonomous Region

Sascha Klotzbücher et al. China Q. 2010.

Abstract

In 2002, the Chinese leadership announced a change in national welfare policy: Voluntary medical schemes at county level, called the "New Rural Co-operative Medical System" should cover all counties by 2010. This article addresses the main characteristics of this system, analyses the introduction of local schemes based on our own field studies in one Kazak county of the Xinjiang Uyghur Autonomous Region since 2006, and argues that the fast progressing of the local scheme and the flexibility shown by local administrators in considering structural and procedural adjustments are not the result of central directives but of local initiatives. Recentralization from the township governments to functional departments in the provincial and the central state administration is only one aspect of current rural governance. Complementary forms of locally embedded responsiveness to the needs of health care recipients are crucial in restructuring the administration and discharge of health care. These new modes of governance are different from the hierarchical control and institutionalized representation of interests of the local population.

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Figure 1

Administration of New Rural Co-operative Medical System (simplified)

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References

    1. NRCMS definition in 2003: “[It] provides mutual help and benefit, mainly focusing on and curing heavy diseases. It is organized, led and supported by the government and with voluntary participation of the farmers. The system is financed jointly by individuals, collectives and government,”
    2. “Guanyu jianli xinxing hezuo yiliao zhidu yijian” (“Opinions about the introduction of NRCMS”) Guobanfa. 2003 Jan 16;(No. 3) http://www.jswst.gov.cn/dfnewsdisplay.php?newsid=436. accessed 13 May 2006.
    1. “Zhonggong zhongyang guowuyuan guanyu jin yibu jiaqiang nongcun weisheng gongzuo de jueding” (“Decision of the Central Committee of the CP and the State Council to strengthen health work in rural areas”) Zhongfa. 2002 Oct 30;(No. 13) http://www.agri.gov.cn/zcfg/t20021107_22649.htm. accessed 3 April 2003.
    2. This policy was expanded to other regions in 2006.
    3. “Guanyu jiakuai tuijin xinxing nongcun hezuo yiliao shidian gongzuo de tongzhi” (“Circular about speeding up the introduction of pilots of NRCMS”) Weinongweifa. 2006 Jan 19;(No. 13) http://www.moh.gov.cn/public/open.aspx?n_id=11283. accessed 12 May 2006.
    1. See the following regarding the Co-operative Medical System before 2002:
    2. Yuanli Liu, Rao Keqin, Hu Shanlian. People’s Republic of China. Toward Establishing a Rural Health Protection System. Asian Developing Bank; Manila: 2002. http://www.adb.org/documents/reports/RC_rural_health_protection_system/p.... accessed 26 November 2004.
    3. Klotzbücher Sascha. Das ländliche Gesundheitswesen der VR China. Strukturen – Akteure – Dynamik. Peter Lang; Frankfurt am Main: 2006.
    4. Regarding the NRCMS see
    5. Weisheng tongji xinxi zhongxin . Zhongguo xinxing nongcun hezuo yiliao jinzhan jiqi xiaoguo yanjiu (Research on Development and Effectiveness of China’s New Rural Co-operative Medical Scheme) Zhongguo xiehe yiyuan daxue chubanshe; Beijing: 2007.
    6. Yuanli Liu. Development of the rural health insurance system in rural China. Health Policy and Planning. 2004;Vol. 19(No. 3):159–65. - PubMed
    7. Duckett Jane. Local governance, health financing, and changing patterns of inequality in access to health care. In: Shue Vivienne, Wong Christine., editors. Paying for Progress in China: Public Finance, Human Welfare and Changing Patterns of Inequality. Routledge; London: 2007. pp. 46–68.
    8. Hong Wang, Licheng Zhang, Yip Winnie, Hsiao William. Adverse selection in a voluntary rural mutual health care health insurance scheme in China. Social Science & Medicine. 2006;Vol. 63(No. 5):1236–45. - PubMed
    9. Jackson Sukhan, Sleigh Adrian C., Peng Li, Xi-li Liu. Health finance in rural Henan: low premium insurance compared to the out-of-pocket system. The China Quarterly. 2005;(No. 181):137–52.
    1. This article does not discuss the minority population aspects, and how they might affect the “responsiveness” of the administrators.
    1. See
    2. Treib Oliver, Bähr Holger, Falkner Gerda. Modes of governance: towards a conceptual clarification. Journal of European Public Policy. 2007;Vol. 14(No. 1):1–20. 5–11.
    3. An example is
    4. Dali Yang. Remaking the Chinese Leviathan: Market Transition and the Politics of Governance in China. Stanford University Press; Stanford: 2004.

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