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Study on the construction of the New Cooperative Medical Scheme management and executive system

Date: Poster sessions
Source: Forum 11
Authors: Wang Zaoli, Vice Director, Center for China Cooperative Medical Scheme, People's Republic of China
with Song Daping, Zhao Donghui, Ren Jing, Liu Yonghua, Wang Bing and Hu Shoujing

Abstract

The New Cooperative Medical Scheme (NCMS) has completed its pilot phase and entered the expansion phase. Consequently, the national NCMS management and executive system faces great challenges. To investigate the status of the scheme and to investigate problems in institution set-up, human resources structure, management costs and function at each level of the system, and to make corresponding policy recommendations, this study will provide a theoretical and statistical reference to the government, and help ensure the healthy running of the scheme.

The study employed the following methods: 1) Document and literature review: relevant materials on the management system, international experiences in managing health insurance schemes, and NCMS working papers, etc. were reviewed 2) Questionnaire and field research: At the time when the research was conducted, there were three categories of counties implementing the NCMS, distinguished by starting time. Approximately four counties were sampled from each category, in ten provinces, selected according to geographical location and socioeconomic development, in total 144 samples. Questionnaires about the construction of county-level and town-level systems were conducted, followed by data entry and analysis. Field research was also conducted in a number of counties to strengthen understanding. 3) Data analysis from the National NCMS Statistical Forms, 2005: Data on the county-level system was analysed to reveal status and problems.

The overall framework of the national NCMS management and executive system has been established. However, the construction of the management departments at national, provincial and municipal level needs to be strengthened, while the construction of the executive institutions and offices at county- and town-levels needs to be regulated. The present system is faced with the following problems: 1) The set- up of the management departments and the executive institutions is inappropriate in some areas, which creates a lack of reasonable management and executive functions in these areas. 2) Human resources need expansion; the present team is unstable, and the literacy of the personnel needs improvement. 3) Deficient fiscal input is causing unwarranted financial allocation.

Based on research findings, the following policy recommendations are made: 1) regulate system management and strengthen policy guidance; 2) optimize human resource allocation and strengthen capacity-building; 3) increase financial input to support system function; 4) construct a unified executive office for the NCMS and the Basic Medical Insurance for the Urban Employee scheme.