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2011年湖南省桑植县正式实施《新型农村合作医疗参合农民乡镇住院全报销实施方案(试行)》和《新型农村合作医疗参合农民乡镇住院全报销实施细则(试行)》,这项制度的实施使有“国家级贫困县”之名的桑植,成为“穷县富医改”的新模式而得到当地政府的肯定,农民参合积极性高涨,政策效果较好。但依靠国家“新农合基金”及县级财政投入支撑的“乡镇住院全报销”政策是否具备长期的兜底能力以维持政策的可持续性,还有待于更进一步探讨和反思。因此,从公共政策研究视角,结合该县“新农合”政策的实施对影响政策过程可持续性的因素进行深层次分析,剖析该政策可持续执行过程中可能面临的困境,深入挖掘其产生的根源,并在总结其经验的基础上探讨该政策的良性循环及其可持续性路径,防止出现推行后期制度、资金等方面难以为继的局面,对于该模式的适度推广至关重要。
In 2011, Sangzhi County, Hunan Province formally implemented the implementation plan (Trial Implementation) of New Rural Cooperative Medical Services for All Inpatient Hospital Retirement Reimbursement (Trial Implementation) and the Implementation Rules of New Rural Cooperative Medical Service for Full Hospitalization Expenses of Peasants (Trial Implementation) Sangzhi, a county with the title of “national-level poor county”, has been recognized by the local government as a new model of “poverty-stricken county and county health reform.” The enthusiasm of peasants is high and the policy is effective. However, the long-term capability of relying on the “new rural cooperative fund” and the county-level financial support to maintain the sustainability of policies is yet to be further explored and reconsidered. Therefore, from the perspective of public policy research, combined with the implementation of the “New Rural Cooperative Medical System” policy in this county, we make an in-depth analysis of the factors that affect the sustainability of the policy process and analyze the possible difficulties in the sustainable implementation of the policy. Its root causes, and on the basis of summing up its experience to explore the virtuous circle of the policy and its sustainability path, to prevent the implementation of the latter part of the system, capital and other unsustainable situation, the modest promotion of the modest .