1.新農合醫療制度(du)價值分析

從新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)本身來(lai)看為了(le)(le)(le)(le)讓其能夠與國(guo)(guo)家(jia)發(fa)展(zhan)及(ji)社(she)(she)會(hui)發(fa)展(zhan)達(da)成匹配(pei)，在(zai)其涉及(ji)過(guo)程(cheng)中并(bing)未采取強制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)性措施，也(ye)就(jiu)是(shi)(shi)說農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)對(dui)(dui)參與社(she)(she)保(bao)(bao)具有(you)(you)篩選權(quan)力，這(zhe)(zhe)也(ye)使得(de)相關資(zi)(zi)金籌(chou)備由多方共(gong)同籌(chou)資(zi)(zi)構成。在(zai)籌(chou)資(zi)(zi)過(guo)程(cheng)中政府(fu)無(wu)疑(yi)(yi)占據了(le)(le)(le)(le)主導性地位(wei)，換句話說若要(yao)(yao)保(bao)(bao)持社(she)(she)保(bao)(bao)基金可(ke)穩(wen)定(ding)(ding)運(yun)作必然(ran)需要(yao)(yao)政府(fu)的(de)(de)(de)(de)(de)支(zhi)持，當(dang)然(ran)也(ye)需要(yao)(yao)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)積(ji)極(ji)配(pei)合(he)(he)(he)(he)。一直(zhi)以來(lai)我國(guo)(guo)都是(shi)(shi)典型(xing)(xing)的(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)業大國(guo)(guo)，即便是(shi)(shi)在(zai)國(guo)(guo)家(jia)工(gong)業如此(ci)發(fa)達(da)的(de)(de)(de)(de)(de)今(jin)天依(yi)然(ran)改變不(bu)了(le)(le)(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)業大國(guo)(guo)這(zhe)(zhe)一屬性，這(zhe)(zhe)也(ye)使得(de)國(guo)(guo)家(jia)一直(zhi)對(dui)(dui)“三農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)”問題(ti)都抱有(you)(you)密(mi)(mi)切(qie)的(de)(de)(de)(de)(de)關注。國(guo)(guo)家(jia)明(ming)確指(zhi)出(chu)新(xin)(xin)(xin)(xin)型(xing)(xing)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)合(he)(he)(he)(he)作醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)是(shi)(shi)黨中央(yang)、國(guo)(guo)務(wu)院為解決農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)看病就(jiu)醫(yi)(yi)(yi)問題(ti)而建(jian)立(li)的(de)(de)(de)(de)(de)-項基本醫(yi)(yi)(yi)療(liao)保(bao)(bao)障制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)，這(zhe)(zhe)反也(ye)反映出(chu)了(le)(le)(le)(le)當(dang)與政府(fu)對(dui)(dui)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)生(sheng)(sheng)活的(de)(de)(de)(de)(de)重(zhong)視程(cheng)度(du)(du)(du)(du)(du)。盡(jin)管如此(ci)但依(yi)然(ran)存在(zai)部(bu)分(fen)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)對(dui)(dui)該制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)抱有(you)(you)遲疑(yi)(yi)、觀望態(tai)度(du)(du)(du)(du)(du)，態(tai)度(du)(du)(du)(du)(du)并(bing)不(bu)積(ji)極(ji)。農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)對(dui)(dui)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)的(de)(de)(de)(de)(de)態(tai)度(du)(du)(du)(du)(du)直(zhi)接(jie)決定(ding)(ding)了(le)(le)(le)(le)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)的(de)(de)(de)(de)(de)可(ke)行(xing)性，因(yin)此(ci)在(zai)大力推廣新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)的(de)(de)(de)(de)(de)同時(shi)(shi)應(ying)當(dang)切(qie)實考慮農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)需求，這(zhe)(zhe)樣(yang)才能夠充分(fen)發(fa)揮新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)的(de)(de)(de)(de)(de)實際價值(zhi)。從價值(zhi)角度(du)(du)(du)(du)(du)來(lai)看新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)使農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)生(sheng)(sheng)命權(quan)與健康(kang)權(quan)得(de)到了(le)(le)(le)(le)保(bao)(bao)障。相對(dui)(dui)而言部(bu)分(fen)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)屬于(yu)低收入(ru)群(qun)體，在(zai)家(jia)庭聯產承(cheng)包制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)導向(xiang)下使的(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)家(jia)庭經(jing)濟(ji)條件與社(she)(she)會(hui)聯系(xi)不(bu)緊密(mi)(mi)，當(dang)出(chu)現經(jing)濟(ji)風(feng)(feng)險時(shi)(shi)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)家(jia)庭只能通(tong)過(guo)內部(bu)生(sheng)(sheng)產資(zi)(zi)料進(jin)行(xing)風(feng)(feng)控。假(jia)設農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)不(bu)幸出(chu)現嚴重(zhong)疾(ji)病時(shi)(shi)，那么醫(yi)(yi)(yi)療(liao)費用(yong)將給(gei)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)家(jia)庭帶(dai)(dai)來(lai)巨大的(de)(de)(de)(de)(de)經(jing)濟(ji)壓力，而正是(shi)(shi)這(zhe)(zhe)種(zhong)經(jing)濟(ji)壓力使得(de)部(bu)分(fen)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)放(fang)棄(qi)治(zhi)療(liao)，這(zhe)(zhe)樣(yang)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)健康(kang)必然(ran)得(de)不(bu)到保(bao)(bao)障。新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)價值(zhi)的(de)(de)(de)(de)(de)出(chu)現無(wu)疑(yi)(yi)讓上(shang)述情況(kuang)得(de)到了(le)(le)(le)(le)緩(huan)解，最起碼降(jiang)低了(le)(le)(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)看病的(de)(de)(de)(de)(de)經(jing)濟(ji)負擔，這(zhe)(zhe)對(dui)(dui)于(yu)社(she)(she)會(hui)穩(wen)定(ding)(ding)發(fa)展(zhan)也(ye)有(you)(you)著深遠意義。另一方面(mian)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)也(ye)體現了(le)(le)(le)(le)醫(yi)(yi)(yi)療(liao)資(zi)(zi)源配(pei)置的(de)(de)(de)(de)(de)合(he)(he)(he)(he)理化。相關數據表明(ming)在(zai)衛生(sheng)(sheng)事業投(tou)入(ru)上(shang)，城鎮投(tou)入(ru)幾乎(hu)是(shi)(shi)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)的(de)(de)(de)(de)(de)2倍有(you)(you)余，從中可(ke)以看出(chu)衛生(sheng)(sheng)資(zi)(zi)源分(fen)配(pei)出(chu)現了(le)(le)(le)(le)不(bu)平(ping)衡的(de)(de)(de)(de)(de)狀態(tai)，也(ye)反映出(chu)了(le)(le)(le)(le)城市與農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)的(de)(de)(de)(de)(de)貧富差距。通(tong)過(guo)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)的(de)(de)(de)(de)(de)有(you)(you)效實施從一定(ding)(ding)程(cheng)度(du)(du)(du)(du)(du)上(shang)緩(huan)解了(le)(le)(le)(le)上(shang)述不(bu)平(ping)衡的(de)(de)(de)(de)(de)狀態(tai)，在(zai)政府(fu)帶(dai)(dai)動下實現了(le)(le)(le)(le)對(dui)(dui)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)合(he)(he)(he)(he)作醫(yi)(yi)(yi)療(liao)的(de)(de)(de)(de)(de)補助讓農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)(cun)居民(min)(min)(min)(min)(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)基本權(quan)利得(de)到了(le)(le)(le)(le)保(bao)(bao)證。同時(shi)(shi)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)為農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)抵御(yu)疾(ji)病風(feng)(feng)險提(ti)供了(le)(le)(le)(le)有(you)(you)力的(de)(de)(de)(de)(de)支(zhi)持，特別是(shi)(shi)對(dui)(dui)于(yu)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)(min)(min)(min)(min)因(yin)病致貧、返(fan)貧產生(sheng)(sheng)了(le)(le)(le)(le)極(ji)其有(you)(you)效的(de)(de)(de)(de)(de)控制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作用(yong)。綜(zong)合(he)(he)(he)(he)來(lai)看新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)醫(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)(du)(du)對(dui)(dui)于(yu)促(cu)進(jin)我國(guo)(guo)社(she)(she)會(hui)平(ping)衡發(fa)展(zhan)有(you)(you)著十分(fen)積(ji)極(ji)的(de)(de)(de)(de)(de)意義，同時(shi)(shi)也(ye)是(shi)(shi)全(quan)面(mian)建(jian)設小康(kang)社(she)(she)會(hui)的(de)(de)(de)(de)(de)重(zhong)要(yao)(yao)支(zhi)撐點。

2.新(xin)農合醫療(liao)制(zhi)度特征分析

新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)若要發(fa)揮其實際效用必(bi)(bi)然需要與經(jing)濟社(she)會環(huan)境發(fa)展緊密貼合(he)(he)，而在(zai)不(bu)同時(shi)代(dai)(dai)下(xia)制(zhi)(zhi)(zhi)(zhi)度(du)(du)也具備不(bu)同特征。從(cong)發(fa)展角度(du)(du)來看我(wo)國新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)曾經(jing)出現(xian)(xian)(xian)了(le)(le)(le)多(duo)次(ci)更替并(bing)在(zai)更替過程(cheng)中不(bu)斷(duan)演(yan)變、完善、健全。目前(qian)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)在(zai)社(she)保(bao)(bao)(bao)(bao)(bao)(bao)體(ti)(ti)系(xi)當(dang)(dang)中已經(jing)具備了(le)(le)(le)導向性(xing)(xing)地(di)位，它(ta)與城(cheng)鎮醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)障共同組成了(le)(le)(le)整個(ge)社(she)保(bao)(bao)(bao)(bao)(bao)(bao)體(ti)(ti)系(xi)。在(zai)新(xin)(xin)(xin)(xin)時(shi)期新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)也體(ti)(ti)現(xian)(xian)(xian)了(le)(le)(le)一(yi)定程(cheng)度(du)(du)的時(shi)代(dai)(dai)化特征。首先(xian)在(zai)當(dang)(dang)前(qian)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)當(dang)(dang)中參與了(le)(le)(le)商(shang)(shang)業(ye)(ye)(ye)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)。這種結合(he)(he)擴充(chong)了(le)(le)(le)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)障的范(fan)圍深度(du)(du)，讓(rang)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)的受益面得(de)以增大(da)。在(zai)商(shang)(shang)業(ye)(ye)(ye)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)作(zuo)用下(xia)可(ke)讓(rang)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)費用報(bao)銷(xiao)額(e)度(du)(du)大(da)幅度(du)(du)上升(sheng)使(shi)得(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)障水平得(de)以促(cu)進(jin)(jin)(jin)(jin)。這對于(yu)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)抵御重大(da)疾病(bing)起(qi)到了(le)(le)(le)關鍵性(xing)(xing)的作(zuo)用。當(dang)(dang)商(shang)(shang)業(ye)(ye)(ye)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)與新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)融合(he)(he)后對于(yu)國家來說即可(ke)對醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)進(jin)(jin)(jin)(jin)行層(ceng)(ceng)次(ci)劃分，可(ke)將管(guan)(guan)理、經(jing)辦(ban)以及監管(guan)(guan)工作(zuo)進(jin)(jin)(jin)(jin)行分離(li)來提升(sheng)事務(wu)處理效率。商(shang)(shang)業(ye)(ye)(ye)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)也可(ke)使(shi)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)介入門檻降低，讓(rang)更多(duo)的農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)關注醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)障服(fu)務(wu)并(bing)加入其中。新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)與以往的醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)在(zai)籌資(zi)機制(zhi)(zhi)(zhi)(zhi)上表現(xian)(xian)(xian)了(le)(le)(le)較大(da)的差(cha)異，它(ta)要求各(ge)級政府在(zai)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)基(ji)金(jin)籌集上必(bi)(bi)須(xu)要給予(yu)財(cai)政支持，也就是說政府承擔了(le)(le)(le)出資(zi)義務(wu)，必(bi)(bi)須(xu)向農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村居民(min)參保(bao)(bao)(bao)(bao)(bao)(bao)者提供相(xiang)(xiang)當(dang)(dang)數(shu)額(e)的醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)基(ji)金(jin)。當(dang)(dang)前(qian)新(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)在(zai)保(bao)(bao)(bao)(bao)(bao)(bao)障側重點上強調(diao)了(le)(le)(le)應該建立適應農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村的醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)(bao)障制(zhi)(zhi)(zhi)(zhi)度(du)(du),并(bing)將其付諸于(yu)提升(sheng)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)抵御大(da)疾病(bing)風(feng)險(xian)能力。在(zai)資(zi)金(jin)管(guan)(guan)理上以縣為(wei)統(tong)(tong)籌單位，一(yi)般情況(kuang)下(xia)統(tong)(tong)籌基(ji)金(jin)層(ceng)(ceng)級愈高(gao)，其范(fan)圍也將得(de)到提升(sheng)，以此可(ke)促(cu)進(jin)(jin)(jin)(jin)經(jing)濟體(ti)(ti)相(xiang)(xiang)互促(cu)進(jin)(jin)(jin)(jin)并(bing)增進(jin)(jin)(jin)(jin)了(le)(le)(le)風(feng)險(xian)控制(zhi)(zhi)(zhi)(zhi)能力，降低突發(fa)性(xing)(xing)風(feng)險(xian)給農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)帶來的損失。

3.優(you)化新農(nong)合(he)醫療制度對策分析

3.1完善農村醫療(liao)衛生(sheng)管理(li)體制(zhi)

一、欠(qian)發達地(di)區新型農村(cun)合作醫(yi)療(liao)的(de)環境特點

1.對(dui)推行和(he)參(can)加(jia)“新農(nong)合”的(de)認識(shi)不(bu)(bu)到(dao)位。在欠發(fa)達地(di)(di)(di)區，推行新農(nong)合制(zhi)度首(shou)先遇到(dao)的(de)是(shi)觀(guan)念轉變問題。一方(fang)面(mian)由于(yu)歷(li)史、經(jing)濟、觀(guan)念等多方(fang)面(mian)的(de)情況，地(di)(di)(di)方(fang)政(zheng)(zheng)府對(dui)建立和(he)完善(shan)“新農(nong)合”制(zhi)度的(de)長期性(xing)、艱巨性(xing)和(he)復(fu)雜性(xing)認識(shi)不(bu)(bu)足，對(dui)有(you)關(guan)政(zheng)(zheng)策理(li)解不(bu)(bu)透(tou)，工作(zuo)不(bu)(bu)細，宣傳發(fa)動不(bu)(bu)深(shen)入，管(guan)理(li)粗放，使有(you)些政(zheng)(zheng)策措(cuo)施未能(neng)很好(hao)地(di)(di)(di)貫徹(che)落實(shi)；另一方(fang)面(mian)，一些農(nong)民(min)對(dui)“新農(nong)合”醫(yi)療制(zhi)度還是(shi)存有(you)疑慮：擔心(xin)政(zheng)(zheng)府的(de)資金不(bu)(bu)能(neng)落實(shi)到(dao)位，擔心(xin)醫(yi)療費用(yong)能(neng)不(bu)(bu)能(neng)合理(li)、及(ji)時(shi)、方(fang)便得到(dao)報銷，擔心(xin)醫(yi)療費用(yong)過(guo)高、服務(wu)不(bu)(bu)好(hao)、得不(bu)(bu)到(dao)實(shi)惠(hui)等等。

2.醫(yi)療資源缺乏和政府監(jian)管缺位。醫(yi)療衛(wei)生資源是(shi)(shi)人(ren)(ren)民健康保障的(de)(de)前提和基礎，而(er)對(dui)(dui)于經濟社會相對(dui)(dui)落(luo)后的(de)(de)中(zhong)西部省(sheng)份來說，農(nong)村(cun)新型合作(zuo)(zuo)醫(yi)療工作(zuo)(zuo)首先要面對(dui)(dui)的(de)(de)現實問題就是(shi)(shi)衛(wei)生資源總量缺乏和人(ren)(ren)均(jun)衛(wei)生資源的(de)(de)嚴重不足。同時有效監(jian)管這(zhe)些(xie)資源，促使(shi)農(nong)村(cun)醫(yi)療機構提高水平、保證質(zhi)量、規范行(xing)為、控制(zhi)費用就成(cheng)了合作(zuo)(zuo)醫(yi)療制(zhi)度有效運行(xing)的(de)(de)關鍵(jian)，但是(shi)(shi)現實情況是(shi)(shi)，越是(shi)(shi)欠發達地區，監(jian)管越是(shi)(shi)不利。

3.農村居民收入水平低(di)。部分貧困的(de)農村居民受到收入水平低(di)的(de)影(ying)響(xiang)(xiang)而(er)沒(mei)有參與新型(xing)(xing)合(he)作(zuo)醫療(liao)，也(ye)影(ying)響(xiang)(xiang)到新型(xing)(xing)合(he)作(zuo)醫療(liao)的(de)資金籌集，最終影(ying)響(xiang)(xiang)到新型(xing)(xing)合(he)作(zuo)醫療(liao)的(de)參與率。

4.城市化水(shui)平(ping)(ping)低(di)。農(nong)村人口比例(li)高于(yu)全(quan)國(guo)平(ping)(ping)均水(shui)平(ping)(ping)，加上(shang)人均收入(ru)(ru)(ru)水(shui)平(ping)(ping)低(di)，農(nong)村貧困人口和接近(jin)于(yu)貧困線的(de)人口多。在實行新型合作醫(yi)(yi)療的(de)過程中，要(yao)保證(zheng)把低(di)收入(ru)(ru)(ru)家庭(ting)納入(ru)(ru)(ru)進來，必然要(yao)幫助(zhu)他們(men)解決籌資問(wen)題，同時還(huan)要(yao)相(xiang)應加大醫(yi)(yi)療救助(zhu)的(de)力(li)度。

5.地(di)方(fang)(fang)財(cai)政(zheng)(zheng)壓(ya)力大。以經濟欠發達的(de)(de)江西(xi)省為例，2005年(nian)，江西(xi)省年(nian)末(mo)總人(ren)口(kou)4311萬(wan)人(ren)，地(di)方(fang)(fang)財(cai)政(zheng)(zheng)支出564億元，地(di)方(fang)(fang)財(cai)政(zheng)(zheng)收入252.9億元。與(yu)東部地(di)區(qu)人(ren)口(kou)基本接近的(de)(de)遼寧省相比，2005年(nian)地(di)方(fang)(fang)財(cai)政(zheng)(zheng)收入674億元，地(di)方(fang)(fang)財(cai)政(zheng)(zheng)支出1182億元，可見差距十分明顯(xian)。這樣，合作(zuo)醫(yi)療管(guan)理部門運轉(zhuan)經費嚴重短(duan)缺，而這些(xie)地(di)區(qu)的(de)(de)政(zheng)(zheng)府財(cai)力又非常有(you)限，很難自行(xing)解決(jue)。在市、縣級越是經濟落后的(de)(de)地(di)區(qu)必然(ran)影響到合作(zuo)醫(yi)療管(guan)理工作(zuo)的(de)(de)開展。即使按(an)照現有(you)的(de)(de)標準(zhun)，由于合作(zuo)醫(yi)療覆蓋面(mian)的(de)(de)擴大和參合農民(min)人(ren)數的(de)(de)不斷增(zeng)加，省級財(cai)政(zheng)(zheng)的(de)(de)補助(zhu)資金總數將大幅度(du)增(zeng)加，將對地(di)方(fang)(fang)財(cai)政(zheng)(zheng)構成較大壓(ya)力。

為建(jian)立(li)與我縣(xian)經(jing)(jing)濟社(she)會發展水平和(he)農(nong)(nong)民(min)經(jing)(jing)濟承受能力相適應的新(xin)(xin)型農(nong)(nong)村(cun)合(he)作醫療制度，提高農(nong)(nong)民(min)健(jian)康保障(zhang)水平，減輕醫療負擔，緩(huan)解農(nong)(nong)民(min)因(yin)患大(da)病而(er)出現(xian)的因(yin)病致貧(pin)、返貧(pin)問題，根據(ju)國務院辦(ban)公廳《關于(yu)建(jian)立(li)新(xin)(xin)型農(nong)(nong)村(cun)合(he)作醫療制度的意見的通知》和(he)《江西省新(xin)(xin)型農(nong)(nong)村(cun)合(he)作醫療管理辦(ban)法（暫(zan)行）》規定，結合(he)我縣(xian)實際，特制定本辦(ban)法。

第一章總則

第一(yi)條(tiao)新型農(nong)村合作醫療制度是(shi)由(you)政府組織、引導、支持、農(nong)民自愿(yuan)參加，個人、集(ji)體和(he)政府多方籌資，以大病統籌為主的農(nong)民醫療互助共(gong)濟制度。

第(di)二條新型農村合作醫(yi)療(liao)(liao)的(de)(de)資金籌(chou)措(cuo)應與我縣經(jing)濟社會發(fa)展水平、農民家庭經(jing)濟能力(li)和醫(yi)療(liao)(liao)費用需要相(xiang)適應，堅(jian)持以收定支、保障(zhang)適度的(de)(de)原則。

第三條農(nong)民自(zi)愿參(can)加(jia)新型農(nong)村合作(zuo)醫(yi)療，抵御疾病(bing)風險而履行(xing)繳費義務，不能(neng)視為(wei)增(zeng)加(jia)農(nong)民負擔。

第(di)四條科學管(guan)理強化(hua)監督。從實際出發，制定相關可操作(zuo)性政策，健全組織機構，加強資(zi)金管(guan)理，規范醫(yi)療服(fu)務(wu)，強化(hua)對(dui)新型農村合作(zuo)醫(yi)療工作(zuo)的(de)組織監督和民主監督,建立事前、過程、結果的(de)“三公開(kai)”監督制度(du)。

第一章總則

第一條為建立新(xin)型農(nong)(nong)(nong)村合(he)作(zuo)醫療(liao)制度，提高農(nong)(nong)(nong)民健康水平，防止因病致貧、因病返貧，促進全(quan)縣農(nong)(nong)(nong)村經濟(ji)社會(hui)全(quan)面協調(diao)可持續發(fa)(fa)展，根據《中共中央、國(guo)(guo)務院關(guan)于(yu)進一步加(jia)強農(nong)(nong)(nong)村衛生工作(zuo)的(de)(de)(de)決定》（中發(fa)(fa)〔2002〕13號(hao)）、《國(guo)(guo)務院辦公廳轉(zhuan)發(fa)(fa)衛生部等(deng)(deng)部門(men)關(guan)于(yu)建立新(xin)型農(nong)(nong)(nong)村合(he)作(zuo)醫療(liao)制度意見的(de)(de)(de)通知(zhi)》（國(guo)(guo)辦發(fa)(fa)〔2003〕3號(hao)）以及(ji)衛生部等(deng)(deng)七部委局《關(guan)于(yu)加(jia)快(kuai)推進新(xin)型農(nong)(nong)(nong)村合(he)作(zuo)醫療(liao)試點工作(zuo)的(de)(de)(de)通知(zhi)》（衛農(nong)(nong)(nong)衛發(fa)(fa)〔2006〕13號(hao)）等(deng)(deng)文件精神，結合(he)自(zi)治縣實際(ji)，制定本實施辦法。

第二(er)條本辦法所稱新(xin)型(xing)農(nong)村(cun)合作醫(yi)療(liao)制(zhi)度(du)是(shi)指由政府組織、引導(dao)、支持，農(nong)民(min)(min)自愿參與，個人、集體和政府多方(fang)籌(chou)資，以(yi)大(da)病統(tong)籌(chou)為主的(de)農(nong)民(min)(min)醫(yi)療(liao)互(hu)助共濟制(zhi)度(du)。

第三條在自治縣境內的(de)農村居民參加新型合作醫療適用(yong)本辦法。

第(di)四(si)條新(xin)型(xing)農村合作(zuo)醫療實(shi)行農民自愿參加(jia)、多方籌(chou)資(zi)，以收定支、保障適度，基金(jin)統(tong)籌(chou)、互(hu)助(zhu)共(gong)濟，公(gong)開公(gong)平、民主監督(du)的原則。

第五條新型(xing)農村合作醫(yi)療實行(xing)大(da)病住院統籌(chou)加(jia)門診統籌(chou)基金補(bu)償模式，以大(da)病住院統籌(chou)為主。

一、協調小組的職能

負責全市新型農(nong)村合作醫療工作的領導、組織和(he)協調工作，主(zhu)要(yao)職能是：

（一）貫徹落實(shi)國家和省(sheng)委、省(sheng)政(zheng)府有關建立新型農(nong)村合作(zuo)醫療制(zhi)度的方針、政(zheng)策和工作(zuo)要求；

（二）研(yan)究制定我市建立(li)新型農村合作醫療制度(du)的指導意(yi)見并組織實施；

（三）制(zhi)(zhi)定市級(ji)有關部門在建立(li)新(xin)型(xing)農村(cun)合(he)作(zuo)(zuo)(zuo)醫療制(zhi)(zhi)度中的職(zhi)責和任務，協調市級(ji)有關部門各(ge)司其職(zhi)，共同為建立(li)我(wo)市新(xin)型(xing)農村(cun)合(he)作(zuo)(zuo)(zuo)醫療制(zhi)(zhi)度發(fa)揮積極作(zuo)(zuo)(zuo)用；

（四）對全市新(xin)型農村(cun)合作(zuo)醫療工作(zuo)進行督促(cu)、指導和檢查，總結推廣經驗(yan)；

第一章總則

第一條為建(jian)立新型農村合作醫療(liao)制度(du)，提高農民健康水平，防止因病(bing)致貧、因病(bing)返貧，促進全縣農村經濟發(fa)展，根據《中共中央、國(guo)務(wu)院關于進一步加(jia)強農村衛生(sheng)工作的決定(ding)》（中發(fa)〔2002〕13號）、《國(guo)務(wu)院辦公(gong)廳轉發(fa)衛生(sheng)部等(deng)部門關于建(jian)立新型農村合作醫療(liao)制度(du)意見的通(tong)知》（國(guo)辦發(fa)〔2003〕3號）等(deng)文(wen)件精神，結合自(zi)治縣實際，制定(ding)本(ben)實施(shi)辦法。

第二條(tiao)本辦(ban)法所稱新型農(nong)村合作醫(yi)療制度是(shi)指由政府組(zu)織、引導、支(zhi)持，農(nong)民自愿參與，個人、集(ji)體和政府多方籌資，以大病統籌為主的農(nong)民醫(yi)療互助共(gong)濟制度。

第三條在自治縣境(jing)內的農(nong)民參加新型合作醫療適用本辦法(fa)。

第四條新型農村合作醫(yi)療實行農民自愿參加、多(duo)方籌(chou)資(zi)，以收(shou)定支、保障適度，大病統籌(chou)、小病補償，公開公平、民主監督的原則。

第五條新型(xing)農村合作醫療(liao)以大病住院統籌為主，兼顧門診醫療(liao)。

第一章總則

第一條為了(le)深入貫徹落實(shi)“三個代表(biao)”重要思(si)想，完(wan)善農村(cun)醫療保障制度，減(jian)輕(qing)農村(cun)居民醫療負擔，基本(ben)解決農村(cun)中存在(zai)的因病致貧、因病返(fan)貧問題，促進(jin)社會穩(wen)定和經(jing)濟發展，根據《縣建立新型農村(cun)合作醫療制度實(shi)施方案(an)》及有關規(gui)定，制訂本(ben)實(shi)施細則。

第二條我縣(xian)新(xin)型農村合作醫療制(zhi)度是以縣(xian)為單(dan)位統(tong)一籌(chou)(chou)資、統(tong)一管理(li)、集中核算為主要形式的大病統(tong)籌(chou)(chou)合作醫療制(zhi)度。

第三條(tiao)新(xin)型農(nong)村合(he)作醫療基金(jin)（以下簡(jian)稱“基金(jin)”）的(de)籌(chou)集和支付要體現(xian)權利與義務相統一、公開與效率相結合(he)的(de)原則(ze)；基金(jin)籌(chou)集采用(yong)“個人(ren)繳費、集體扶持、政府資(zi)助(zhu)”的(de)原則(ze)。

第四條新型農(nong)(nong)村合(he)(he)作醫(yi)療(liao)參合(he)(he)對象及參合(he)(he)方(fang)式：參合(he)(he)對象為(wei)(wei)戶籍在我縣(xian)的(de)農(nong)(nong)村居民(min)及未參加(jia)城(cheng)鎮職工醫(yi)療(liao)保險的(de)城(cheng)鎮居民(min)，參合(he)(he)時均要以戶為(wei)(wei)單位參加(jia)。

第(di)五(wu)條新型農村合作醫療(liao)制度的(de)實施(shi)年(nian)度為每年(nian)月(yue)日(ri)至月(yue)日(ri)。

第一章總則

第一條為進一步完(wan)善(shan)新型農(nong)(nong)村合作醫療制度，增強農(nong)(nong)民互助共濟意識(shi)，引導農(nong)(nong)民適時、合理就(jiu)醫，提高合作醫療基金(jin)的(de)使(shi)用效率和(he)效益，根據《五峰土家族自治縣新型農(nong)(nong)村合作醫療制度實施辦法》（五政發〔2006〕32號）的(de)有關規定，特(te)制定本辦法。

第(di)二條新(xin)型農村合作醫(yi)療門診統籌實行“縣級監督指導、鄉鎮(zhen)統籌管理(li)”的(de)管理(li)體制。

第二章組織機構

第三條鄉(xiang)鎮合管(guan)辦在鄉(xiang)鎮新型農村合作醫(yi)療管(guan)理委員會的領導(dao)下，負責本辦法的實施和管(guan)理。縣合管(guan)辦對鄉(xiang)鎮門診統(tong)籌實行指導(dao)和監督。

第四條鄉鎮合管辦設立專職(zhi)管理員(yuan)。專職(zhi)管理員(yuan)從鄉鎮衛生院職(zhi)工中擇(ze)優考(kao)核(he)聘用，報(bao)縣合管辦備案。

1新型農村合作(zuo)醫療制度可持續發展的評價標準

新(xin)型(xing)農(nong)村(cun)合(he)作醫療在各地的(de)實踐探索過程中，取得了良好(hao)的(de)效果，也積累了寶貴的(de)經(jing)驗(yan)。但不可否認新(xin)型(xing)農(nong)村(cun)合(he)作醫療制度(du)仍(reng)然存在一些問題。因此，客觀全(quan)面的(de)評價新(xin)型(xing)農(nong)村(cun)合(he)作醫療制度(du)，不僅是(shi)進一步推(tui)動制度(du)完善(shan)的(de)重要手段，也是(shi)其持續、健康發(fa)展(zhan)的(de)必然要求。具體而言，可以以下幾個(ge)方面進行評價:

1．1籌(chou)資(zi)政策(ce)和籌(chou)資(zi)管理的可(ke)持續(xu)

能(neng)籌(chou)(chou)集到足額、持續(xu)的(de)(de)(de)保障資(zi)金(jin)是新(xin)農(nong)合(he)制(zhi)(zhi)度長期(qi)存在(zai)發展的(de)(de)(de)基礎(chu)性條件。只有(you)(you)國(guo)家建立了可(ke)持續(xu)的(de)(de)(de)籌(chou)(chou)資(zi)政(zheng)策，并建立相關(guan)的(de)(de)(de)管理(li)監督體系，才能(neng)實現制(zhi)(zhi)度資(zi)金(jin)來(lai)源(yuan)的(de)(de)(de)穩定，新(xin)農(nong)合(he)制(zhi)(zhi)度才會(hui)擁有(you)(you)長期(qi)穩定運行的(de)(de)(de)前提(ti)。因此，要(yao)實現新(xin)農(nong)合(he)籌(chou)(chou)資(zi)的(de)(de)(de)可(ke)持續(xu)，最重(zhong)要(yao)的(de)(de)(de)就是要(yao)實現政(zheng)策及管理(li)的(de)(de)(de)穩定有(you)(you)效，包括籌(chou)(chou)資(zi)機(ji)制(zhi)(zhi)、補償機(ji)制(zhi)(zhi)和(he)基金(jin)管理(li)機(ji)制(zhi)(zhi)各方面制(zhi)(zhi)度，并合(he)理(li)將(jiang)其與其他農(nong)村(cun)制(zhi)(zhi)度結合(he)，才能(neng)為(wei)新(xin)農(nong)合(he)制(zhi)(zhi)度的(de)(de)(de)可(ke)持續(xu)提(ti)供可(ke)靠的(de)(de)(de)前提(ti)基礎(chu)。

1．2較(jiao)高的(de)農民參合(he)率

新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)的建立是為了保障農(nong)(nong)(nong)民的醫療服務需求。農(nong)(nong)(nong)民的參(can)合(he)(he)(he)率(lv)(lv)在很(hen)大程度(du)(du)上取決于農(nong)(nong)(nong)民對新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)的了解程度(du)(du)和認可率(lv)(lv)，只(zhi)有農(nong)(nong)(nong)民對新(xin)農(nong)(nong)(nong)合(he)(he)(he)認可，才能(neng)有效實(shi)現(xian)新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)的可持續(xu)，只(zhi)有農(nong)(nong)(nong)民從新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)中獲得預期收(shou)益、得到實(shi)惠才會(hui)踴躍參(can)與(yu)新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)，并最終促進(jin)新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)的可持續(xu)發展。因(yin)此，為了實(shi)現(xian)新(xin)農(nong)(nong)(nong)合(he)(he)(he)制(zhi)度(du)(du)的可持續(xu)，提高農(nong)(nong)(nong)民的參(can)合(he)(he)(he)率(lv)(lv)就必(bi)須設(she)計惠及農(nong)(nong)(nong)民的制(zhi)度(du)(du)，并對制(zhi)度(du)(du)進(jin)行(xing)廣泛(fan)宣傳，促使農(nong)(nong)(nong)民積(ji)極參(can)保。

一、新農合制(zhi)度對醫療需求方———農牧民的影響(xiang)

（一）農牧民參(can)與新農合的狀況

1.農牧(mu)民參與水平及其原因

截至2007年(nian)底，調(diao)查(cha)樣本(ben)(ben)(ben)鄉(xiang)鎮（蘇木(mu)）全(quan)部(bu)(bu)(bu)實施(shi)了(le)(le)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)型(xing)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)合(he)(he)(he)(he)(he)(he)(he)作(zuo)(zuo)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)，覆蓋率為(wei)(wei)(wei)(wei)100%，農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)牧(mu)(mu)區(qu)居(ju)民(min)(min)(min)(min)(min)參(can)(can)(can)(can)(can)(can)(can)合(he)(he)(he)(he)(he)(he)(he)率為(wei)(wei)(wei)(wei)89.15%，并且(qie)自(zi)(zi)愿參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)比(bi)例(li)超(chao)過了(le)(le)95%。這(zhe)表(biao)明(ming)，農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)對實施(shi)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)存在(zai)著(zhu)潛在(zai)的(de)(de)(de)(de)(de)(de)(de)(de)需(xu)求，新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)的(de)(de)(de)(de)(de)(de)(de)(de)推行得到了(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)(de)(de)(de)基(ji)本(ben)(ben)(ben)認可(ke)，農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)具(ju)有較(jiao)(jiao)高的(de)(de)(de)(de)(de)(de)(de)(de)參(can)(can)(can)(can)(can)(can)(can)與(yu)積極(ji)性。盡管農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)(de)(de)(de)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)參(can)(can)(can)(can)(can)(can)(can)與(yu)率較(jiao)(jiao)高，但仍有近10.85%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)沒有參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)。研究和(he)(he)探(tan)討(tao)究竟哪些(xie)(xie)因(yin)素制(zhi)(zhi)(zhi)(zhi)約(yue)了(le)(le)這(zhe)些(xie)(xie)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)，對于(yu)(yu)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)的(de)(de)(de)(de)(de)(de)(de)(de)推廣和(he)(he)普及具(ju)有重要(yao)(yao)(yao)(yao)意義(yi)。根據調(diao)查(cha)表(biao)明(ming)，制(zhi)(zhi)(zhi)(zhi)約(yue)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)因(yin)素大(da)(da)(da)體可(ke)以(yi)(yi)(yi)歸為(wei)(wei)(wei)(wei)三類：一(yi)類是(shi)(shi)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)自(zi)(zi)身因(yin)素導致農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)，另一(yi)類是(shi)(shi)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)設計(ji)上(shang)(shang)(shang)的(de)(de)(de)(de)(de)(de)(de)(de)問(wen)(wen)題制(zhi)(zhi)(zhi)(zhi)約(yue)了(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)民(min)(min)(min)(min)(min)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)，還(huan)有一(yi)類是(shi)(shi)其(qi)(qi)他原(yuan)(yuan)因(yin)。農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)由于(yu)(yu)自(zi)(zi)身原(yuan)(yuan)因(yin)而(er)(er)(er)放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)比(bi)例(li)為(wei)(wei)(wei)(wei)36.96%（見(jian)表(biao)2）。其(qi)(qi)中(zhong)，19.57%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)因(yin)為(wei)(wei)(wei)(wei)平時比(bi)較(jiao)(jiao)健(jian)康(kang)、很少生(sheng)病(bing)(bing)(bing)而(er)(er)(er)放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)，這(zhe)部(bu)(bu)(bu)分農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)(de)(de)(de)平均(jun)年(nian)齡在(zai)36歲。由此可(ke)見(jian)，在(zai)自(zi)(zi)愿參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)的(de)(de)(de)(de)(de)(de)(de)(de)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)下(xia)(xia)，新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)存在(zai)著(zhu)一(yi)定(ding)(ding)程度(du)(du)(du)的(de)(de)(de)(de)(de)(de)(de)(de)逆向(xiang)選(xuan)擇行為(wei)(wei)(wei)(wei)，即身體健(jian)康(kang)的(de)(de)(de)(de)(de)(de)(de)(de)年(nian)輕人(ren)往(wang)(wang)往(wang)(wang)會放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)；15.22%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)因(yin)已經(jing)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)了(le)(le)公費(fei)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)、學生(sheng)意外(wai)傷害保(bao)險(xian)等其(qi)(qi)他健(jian)康(kang)保(bao)險(xian)而(er)(er)(er)沒有參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)型(xing)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)合(he)(he)(he)(he)(he)(he)(he)作(zuo)(zuo)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)；只有2.17%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)因(yin)為(wei)(wei)(wei)(wei)經(jing)濟(ji)(ji)困難而(er)(er)(er)沒有參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)。相(xiang)比(bi)之(zhi)下(xia)(xia)，農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)由于(yu)(yu)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)設計(ji)不(bu)完善而(er)(er)(er)未(wei)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)比(bi)例(li)較(jiao)(jiao)大(da)(da)(da)，達到45.65%（見(jian)表(biao)2）。其(qi)(qi)中(zhong)，8.70%放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)認為(wei)(wei)(wei)(wei)報銷手續太(tai)復雜，為(wei)(wei)(wei)(wei)了(le)(le)報銷有限的(de)(de)(de)(de)(de)(de)(de)(de)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)藥(yao)費(fei)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)需(xu)要(yao)(yao)(yao)(yao)花費(fei)較(jiao)(jiao)多(duo)的(de)(de)(de)(de)(de)(de)(de)(de)時間(jian)成本(ben)(ben)(ben)，從經(jing)濟(ji)(ji)上(shang)(shang)(shang)來說不(bu)合(he)(he)(he)(he)(he)(he)(he)算(suan)。對上(shang)(shang)(shang)繳(jiao)的(de)(de)(de)(de)(de)(de)(de)(de)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)費(fei)管理不(bu)信任(ren)而(er)(er)(er)不(bu)愿意參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)的(de)(de)(de)(de)(de)(de)(de)(de)比(bi)例(li)為(wei)(wei)(wei)(wei)4.35%，這(zhe)主要(yao)(yao)(yao)(yao)是(shi)(shi)因(yin)為(wei)(wei)(wei)(wei)在(zai)以(yi)(yi)(yi)前的(de)(de)(de)(de)(de)(de)(de)(de)合(he)(he)(he)(he)(he)(he)(he)作(zuo)(zuo)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)實行時期，很多(duo)地(di)方都(dou)出(chu)現了(le)(le)挪用農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)合(he)(he)(he)(he)(he)(he)(he)作(zuo)(zuo)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)資(zi)金和(he)(he)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)交錢(qian)、干部(bu)(bu)(bu)吃藥(yao)的(de)(de)(de)(de)(de)(de)(de)(de)問(wen)(wen)題，這(zhe)嚴(yan)重損害了(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)的(de)(de)(de)(de)(de)(de)(de)(de)利益，影響了(le)(le)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)對新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)信任(ren)。還(huan)有2.17%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)認為(wei)(wei)(wei)(wei)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)指定(ding)(ding)的(de)(de)(de)(de)(de)(de)(de)(de)村(cun)診(zhen)(zhen)(zhen)所(suo)(suo)、鄉(xiang)衛生(sheng)院(yuan)或縣(xian)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)的(de)(de)(de)(de)(de)(de)(de)(de)藥(yao)品價格和(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)服(fu)務價格比(bi)其(qi)(qi)他醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)機構(gou)要(yao)(yao)(yao)(yao)高，雖然新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)對部(bu)(bu)(bu)分醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)藥(yao)費(fei)進行報銷，但最(zui)終從新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)受益的(de)(de)(de)(de)(de)(de)(de)(de)不(bu)是(shi)(shi)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)而(er)(er)(er)是(shi)(shi)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)機構(gou)。由于(yu)(yu)在(zai)外(wai)地(di)打工或工作(zuo)(zuo)而(er)(er)(er)放棄(qi)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)工所(suo)(suo)占比(bi)例(li)最(zui)大(da)(da)(da)，達到19.57%。這(zhe)主要(yao)(yao)(yao)(yao)是(shi)(shi)由于(yu)(yu)大(da)(da)(da)部(bu)(bu)(bu)分實施(shi)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)地(di)區(qu)規定(ding)(ding)僅補(bu)償在(zai)本(ben)(ben)(ben)旗(qi)縣(xian)內(nei)指定(ding)(ding)的(de)(de)(de)(de)(de)(de)(de)(de)旗(qi)縣(xian)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)、鄉(xiang)衛生(sheng)院(yuan)或村(cun)診(zhen)(zhen)(zhen)所(suo)(suo)看病(bing)(bing)(bing)發生(sheng)的(de)(de)(de)(de)(de)(de)(de)(de)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)費(fei)用，到旗(qi)縣(xian)外(wai)就醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)所(suo)(suo)發生(sheng)的(de)(de)(de)(de)(de)(de)(de)(de)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)費(fei)用需(xu)要(yao)(yao)(yao)(yao)旗(qi)縣(xian)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)開具(ju)相(xiang)應的(de)(de)(de)(de)(de)(de)(de)(de)轉診(zhen)(zhen)(zhen)手續才能予以(yi)(yi)(yi)補(bu)償。而(er)(er)(er)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)牧(mu)(mu)區(qu)許多(duo)外(wai)出(chu)務工農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)是(shi)(shi)到外(wai)旗(qi)縣(xian)、甚至是(shi)(shi)到外(wai)省市務工，需(xu)要(yao)(yao)(yao)(yao)花費(fei)一(yi)定(ding)(ding)的(de)(de)(de)(de)(de)(de)(de)(de)時間(jian)成本(ben)(ben)(ben)和(he)(he)經(jing)濟(ji)(ji)成本(ben)(ben)(ben)。另外(wai)，有17.39%的(de)(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)因(yin)為(wei)(wei)(wei)(wei)年(nian)齡太(tai)大(da)(da)(da)、病(bing)(bing)(bing)情太(tai)重或因(yin)年(nian)齡太(tai)小不(bu)符合(he)(he)(he)(he)(he)(he)(he)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)條件等原(yuan)(yuan)因(yin)沒有參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)型(xing)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)村(cun)合(he)(he)(he)(he)(he)(he)(he)作(zuo)(zuo)醫(yi)(yi)(yi)(yi)(yi)(yi)(yi)(yi)療(liao)。綜上(shang)(shang)(shang)所(suo)(suo)述(shu)，農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)不(bu)愿意參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)既有農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)自(zi)(zi)身的(de)(de)(de)(de)(de)(de)(de)(de)原(yuan)(yuan)因(yin)，也有新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)設計(ji)上(shang)(shang)(shang)的(de)(de)(de)(de)(de)(de)(de)(de)原(yuan)(yuan)因(yin)，然而(er)(er)(er)，新(xin)(xin)(xin)(xin)(xin)(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)合(he)(he)(he)(he)(he)(he)(he)制(zhi)(zhi)(zhi)(zhi)度(du)(du)(du)本(ben)(ben)(ben)身不(bu)完善則(ze)構(gou)成了(le)(le)制(zhi)(zhi)(zhi)(zhi)約(yue)農(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)民(min)(min)(min)(min)(min)參(can)(can)(can)(can)(can)(can)(can)加(jia)(jia)(jia)(jia)(jia)(jia)(jia)(jia)的(de)(de)(de)(de)(de)(de)(de)(de)主要(yao)(yao)(yao)(yao)原(yuan)(yuan)因(yin)。

2.農牧民對新農合制度的(de)認知程(cheng)度

一(yi)項新(xin)(xin)(xin)政策(ce)(ce)實(shi)施的(de)(de)(de)(de)(de)(de)(de)前提條件是參(can)與各(ge)方對(dui)(dui)政策(ce)(ce)本(ben)(ben)身(shen)有充分的(de)(de)(de)(de)(de)(de)(de)了解(jie)(jie)。新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合醫療(liao)的(de)(de)(de)(de)(de)(de)(de)目的(de)(de)(de)(de)(de)(de)(de)在于(yu)通過(guo)對(dui)(dui)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)醫療(liao)開支的(de)(de)(de)(de)(de)(de)(de)補(bu)(bu)償(chang)來(lai)減輕農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)由于(yu)醫療(liao)支出(chu)所帶來(lai)的(de)(de)(de)(de)(de)(de)(de)經(jing)濟負擔。因此，農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)對(dui)(dui)新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合制(zhi)度的(de)(de)(de)(de)(de)(de)(de)認(ren)知(zhi)在很大(da)程(cheng)度上體現為農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)對(dui)(dui)新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合補(bu)(bu)償(chang)范(fan)圍的(de)(de)(de)(de)(de)(de)(de)認(ren)知(zhi)程(cheng)度。農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)了解(jie)(jie)新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合的(de)(de)(de)(de)(de)(de)(de)主(zhu)要途徑是鄉村干部的(de)(de)(de)(de)(de)(de)(de)宣傳，其次是電視、廣播及報紙等(deng)媒(mei)體的(de)(de)(de)(de)(de)(de)(de)宣傳。調(diao)查發現，新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合制(zhi)度在運行過(guo)程(cheng)中(zhong)(zhong)面臨的(de)(de)(de)(de)(de)(de)(de)一(yi)個(ge)突出(chu)問題是，農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)對(dui)(dui)本(ben)(ben)旗(qi)實(shi)行的(de)(de)(de)(de)(de)(de)(de)新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合的(de)(de)(de)(de)(de)(de)(de)補(bu)(bu)償(chang)類型(xing)和(he)補(bu)(bu)償(chang)范(fan)圍的(de)(de)(de)(de)(de)(de)(de)理解(jie)(jie)與政策(ce)(ce)宣傳的(de)(de)(de)(de)(de)(de)(de)內容存在偏差。根(gen)據新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合的(de)(de)(de)(de)(de)(de)(de)政策(ce)(ce)文件，在所調(diao)查的(de)(de)(de)(de)(de)(de)(de)樣本(ben)(ben)村中(zhong)(zhong)，參(can)加新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合的(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)可(ke)以報銷(xiao)門診費(fei)和(he)住(zhu)院(yuan)費(fei)。然而(er)，根(gen)據對(dui)(dui)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)戶的(de)(de)(de)(de)(de)(de)(de)訪談，7%的(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)認(ren)為，他們(men)參(can)加的(de)(de)(de)(de)(de)(de)(de)新(xin)(xin)(xin)農(nong)(nong)(nong)(nong)(nong)(nong)合僅能(neng)(neng)補(bu)(bu)償(chang)門診費(fei)；25%的(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)認(ren)為，僅住(zhu)院(yuan)費(fei)能(neng)(neng)夠報銷(xiao)；57%的(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)回答，門診費(fei)和(he)住(zhu)院(yuan)費(fei)都可(ke)以報銷(xiao)；還(huan)有近11%的(de)(de)(de)(de)(de)(de)(de)農(nong)(nong)(nong)(nong)(nong)(nong)牧(mu)(mu)(mu)(mu)(mu)民(min)(min)說不清楚(chu)合作(zuo)醫療(liao)到底能(neng)(neng)補(bu)(bu)償(chang)門診費(fei)還(huan)是住(zhu)院(yuan)費(fei)（見(jian)表3）。由此可(ke)見(jian)，今(jin)后應(ying)該進一(yi)步加大(da)宣傳力(li)度，提高宣傳的(de)(de)(de)(de)(de)(de)(de)效率。