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我国当前实施初级卫生保健的一个显著特点就是建立以集体办的乡村两级卫生机构为基础,以合作医疗为主体的农村医疗保健制度。而合作医疗的主要内容是集资医疗,依靠农民的自身力量,采取互助共济形式,防止因病致贫情况的发生,以达到人人享受初级卫生保健的目的。合作医疗制度在我国已有相当长的历史,80年代初因种种原因而发生解体。按理说以集资医疗为主要内容的合作医疗是有一定的群众基础的,恢复起来不应该有很大难度。但是目前,笔者在绍兴市农村进行初级卫生保健工作调查中发现,集资医疗的难度很大,超出了人们的一般预料。归纳分析,主要有以下几个原因。
One of the distinctive features of China’s current implementation of primary health care is the establishment of a rural health care system based on a collectively-run, rural-level and two-tiered health institution, with cooperative medical care as the mainstay. The main content of cooperative medical care is fund-raising medical care, relying on the peasants’ own power, taking the form of mutual aid and mutual aid, and preventing the occurrence of poverty due to illness so as to achieve the goal of everyone enjoying primary health care. The cooperative medical system has a long history in China, and it has been disintegrated for various reasons in the early 1980s. It is reasonable to say that cooperative medical care with fund-raising as its main content has a certain mass base, and recovery should not be difficult. However, at present, the author conducted a survey of primary health care work in the countryside of Shaoxing City and found that the fund-raising medical treatment is very difficult and exceeds people’s general expectations. Inductive analysis mainly has the following reasons.