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在我国广泛实施的新型农村合作医疗由于制度设计本身的缺陷,其实施面临着一定的局限和困境,影响了农民的参合意愿及满意度,使新型农村合作医疗的制度绩效大打折扣。制度困境主要表现在5个方面:农民自愿参与催生逆向选择和道德风险使新型农村合作医疗面临可持续困境、新型农村合作医疗的公益性与商业性的博弈困境、中央政策与地方政府利益博弈困境、以家庭为单位参合与城市化及社会保障转变的冲突困境、大病统筹下的补偿模式困境,结合新型农村合作医疗的运行机理,提出了相应的对策建议。
Due to the defects of the system design, the implementation of the new rural cooperative medical system in our country faces some limitations and difficulties, affects the willingness and willingness to participate of the farmers and greatly reduces the institutional performance of the new rural cooperative medical system. The predicament of the system is mainly manifested in five aspects: the voluntary participation of peasants in the birth of adverse selection and moral hazard faces the sustainable dilemma of the new rural cooperative medical system, the public welfare and commercial game predicament of the new rural cooperative medical system, the predicament of central government and the interests of local governments , Taking the family as a unit to participate in the conflict dilemma of urbanization and social security transformation and the compensation mode dilemma under the serious illness co-ordination, combined with the operation mechanism of the new rural cooperative medical system, put forward corresponding countermeasures and suggestions.