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中国农村医疗保障制度,以合作医疗制度的发展为主线,经历了产生、发展、鼎盛、崩溃和复兴历程。研究中国农村医疗保障制度的变迁,具有重要的理论价值和现实意义。本文从上世纪30年代的自发的探索到本世纪的新型农村合作医疗制度的建立,回顾和比较了将近半个多世纪变迁历程,分析其变迁的原因,并在此基础上提出进一步改革的方向应该处理好“自愿”与“强制”、“本地化”和“流动性”以及“保大”与“保小”间的关系。
China’s rural medical security system, with the development of the cooperative medical system as the main line, has experienced the process of emergence, development, prosperity, collapse and revival. Studying the changes of rural medical security system in China has important theoretical and practical significance. From the spontaneous exploration in the 1930s to the establishment of a new type of rural cooperative medical system in this century, this paper reviews and compares the vicissitudes of more than half a century and analyzes the reasons for its change. On this basis, it puts forward the direction of further reforms The relationship between “Voluntary ” and “Forced ”, “Localized ” and “Liquidity ”, and “Paul Big ” and “Paul Small ” should be handled.