The new rural cooperative medical system has achieved periodical achievements since its establishment. Nevertheless, there are many factors hampering the development of the new system, such as the high cost, the difficulties in fund procurement, the lack of management, the narrow beneficial range for farmers, the ineffective constraint to the designated medical institutions, the high fund surplus rate, and the poor medical facilities and services in rural areas. countermeasures are put forward to solve these problems, including improving the system design, expanding the coverage of the system, diversifying the funding sources, reducing the financing costs, strengthening the fund supervision, enhancing the supervision of designated medical institutions, and improving the capacity of health services in rural areas.%新型农村合作医疗制度自运行以来取得了较好的社会成效,但是在运行的过程中也暴露出一些问题:在制度设计上,以大病统筹为主,致使参合农民受益面过窄;以收定支,自愿参加,造成新农合基金结余率居高不下;实际运行中,资金筹集难度大、成本高,管理存在缺陷;对定点医疗机构缺乏行之有效的约束;农村医疗设施落后,服务能力薄弱.针时这些问题,提出了相应的制度改进建议:完善制度设计,扩大受益面;广开筹资渠道,降低筹资成本,加强基金监管;加大对定点医疗机构的监管力度;切实提高农村医疗卫生服务能力.
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