一、农村医疗保险现状1.1农村保障水平低low level of rural securityAgricultural population accounts for 63.91% of the population in our country, and in the countryside of 100 individuals, only 12 people enjoy in different degrees in business or social medical insurance as a whole, it is 54 in large and medium-sized cities. Officially adopted in 1999 from social security reform, has been 108950 people, nearly 65% are town enterprise worker and retiree, and farmers enjoy the security of society is extremely low, as in the various commercial and social insurance society to plan as a whole with the most serious illness medical insurance coverage of less than 20%. Moreover, 79% of the rural farmers' medical expense, low level of security, China's social security in cities is not enough, only make the farmers enjoy the social security is one of the important link of economic construction in our country.1.2 The rural investment is insufficient, the gap between urban and rural areasOver the years, we follow in the economic and social development is tilted to the city's train of thought, for a long time in our country urban and rural health resource allocation imbalance, accounting for 70% of the country's rural population accounts for 30% of the health resources. Rural medical insurance funds seriously insufficient. With the development of the rural tax and fee reform, the local finance tight, many village collective economy is running out, less subsidies for rural health institutions, lack of rural health resource will be more.1.3 "poverty due to illness" phenomenon is seriousAt present, in China's vast rural areas, the medical service supply market gradually, out-of-pocket medical system still dominate, rural medical service costs continue to rise, "because of sickness poor," "sick to go to a doctor" is not accidental phenomenon in the rural areas, farmers concern for patients. Peasants' medical expenses in recent years, rising more than the actual average farmer income growth. Many farmers have been unable to bear the increasing medical expenses, form a "slight illness, resistance to" general situation. The contradiction in China's rural medical and health security must reform rural medical insurance system, otherwise the rural medical and health work, such as family planning, the management of infectious diseases, epidemic control and other issues, will face serious challenge. A lot of theoretical research and practical experience shows that in the rural new cooperative medical insurance system is imperative.1.4 The new type of rural cooperative medical care systemthere are a lot of defectsFirst of all, the lack of incentive mechanism for farmers ginseng protect enthusiasm is not high, due to the new rural cooperative medical care system is for the purpose of a poverty-stricken population, mainly solve the farmers' burden of medical treatment of a serious illness. And suffer from a serious illness have a chance, therefore, the farmers will because of small and don't want to risk of developing a serious illness insurance to plan as a whole. Second, loopholes in management, finance, the individual place some violation of central on the new ruralcooperative medical care system pilot policies and guidelines. In addition, ignore the differences between regions, different levels cannot meet farmers' health care problem.2 the problem of rural health insurance in our country2.1 the new type of rural cooperative medical care system of legal construction lagChina has 80% of the population live in rural areas, stable unstable China first to see this 80% stable instability. Cities make again beautiful, without the stability of the countryside is based on no. Enacted in October 2002, the party central committee and the state council on further strengthening rural health work of the decision "also explicitly pointed out:" the rural health work is the key of the health work in China, related to the protection of rural productivity, to prosper rural economy, maintain the overall situation of rural social development and stability, to improve the quality of the whole nation is of great significance ". Such an important event to constructing harmonious society, in the process of implementation, no corresponding policies and laws, implementing measures, formulate specific provisions will be different. Even the hangzhou area adjacent counties policy difference is very big also, farmers enjoy the security level is uneven, affect the credibility of the system.2.2 the functions of the government is not clearThe management function of government is not appropriate, some not clear its role in the health care system should be borne by the government's services and products, the government will turn the provided by the market, make the countryside poorerunderserved population lack access to basic medical and health services. And some of this should be mainly provided by the market and distribution of medical service resources, the government has the burden. For a long time, the government provided directly to rely too much on medical service, the excessively centralized control of medical facilities, and dominated by the government, finance, information and the rules and regulations tool, the use of too little. In the survey, farmers generally reflect that the poor can get money, rich people got sick can take out money, but afraid to pay money every year not sick, obvious disadvantage. Many farmers said bluntly mistrust of the village township cadres, fear of changing government policy2..3 Insufficient standard in the work of the orgnaization of agency of medical treatmentManagement good luck good cooperative medical fund, need to establish and improve the relevant institutions, to form effective supervision mechanism, the person in charge should have good professional ethics and high level of professional knowledge. Gap is very big, but, in many parts of the actual situation and problems of the "have-nots”:without formal institutions and professional personnel, no work, no specification system. More part-time person in charge and change frequently, reimbursement approval process trival, sicken farmer reimbursement when the opinion is very large. Fund management supervision mechanism is not sound, transparency is not high, some places even illegal illegal phenomenon such as misappropriation of corruption.2.4 Medical spending is growing rapidly, aggravating the farmers' burdenReality, at present our country a lot of medicine for the medical hospital, auxiliary examination project too much, the price is a little bit higher, leading to hospitalization soaring adverse phenomenon still exists. Many doctors under the huge temptation with retail price difference, prescription, with expensive medicine, inspection and it is indisputable fact that kickbacks. These phenomena on the one hand, causing huge waste of resources, the country's fiscal medicine, at the same time also to the patient especially peasants brought a very heavy burden. And an aging population, the wide application of high and new medical technology, people's demand for medical services, diversification and increased incidence of chronic noncommunicable diseases, public health system is not sound may bring unexpected events will continue to lead to rapid rise in medical costs and so on reasons, how to effectively control medical costs reasonably and realize the medical insurance fund balance of payments is still a problem of the medical security system reform.2.5 Medical and health resources allocation is not reasonableMedical and health resources allocation is unreasonable, the fairness of urban and rural medical security is poor. China's current medical and health resources more focused on regional medium or large hospitals, some small and medium-sized medical institutions infrastructure are not effectively improve for a long time. , from the perspective of urban and rural medical and health resources are concentrated in cities, accounting for80% of the total resources, two-thirds and concentration in a big hospital. Visible, medical and health resource configuration is not reasonable factors of the great. According to the world health organization released health service report disclosed in 2000, 191 countries and regions, medical and health resource allocation fairness index, China, 188, in ranking the fourth from bottom among all members, is one of the most unfair. Medical and health resource configuration is unreasonable, accessibility of rural medical treatment is poor, lead to the vast rural areas farmers ailment, serious despise, see a serious illness means ruin, poverty because of illness. So, rural health care in limbo. This is our country a great miscalculate on health care reform. Become perfect medical security system in China urgently needs to solve a big problem.3 Feasible measures and Suggestions on the development of rural health insurance in China3.1 Expand health care coverage, value gap groups and vulnerable groupsAttaches great importance to the urban and rural gap groups and vulnerable groups, and embodies the country is committed to promoting social justice, the protection of human rights, efforts to reduce the social unstable factor. Medical security in cities and towns construction practice, there are still a lot of people free from the medical insurance, mainly are hard worker population and poverty population in cities and towns, flexible employment people, laid-off workers and unemployed, a large number of migrant workers in cities and rural migrant workers and so on. These are used in the construction of medicalsecurity in cities and towns ignored or still haven't received due and attaches great importance to the open group, their basic health rights haven't be guaranteed.3.2 To strengthen the supervision of medical institutions, to control the excessive rise in medical costsTo strengthen the hospital medical expenses reasonable monitoring, effective control of the excessive growth of medical expenses, to reduce the personal burden by regulating the behavior of medical service, make the limited funds real patients, in order to control medical costs rise, should control the scale enlargement of medical services and internal costs as a key. According to regional health scale, new medical institutions of examination and approval strictly, strictly control the expansion of existing, streamline overlapping unreasonable institutions, adjust straighten out the service function. For medicine, medical market chaos, strengthen the pharmaceutical production, circulation and regulation of medical institutions, is to control the rising cost and the important way to reduce the financial burden of farmers.3.3 Farmers' basic medical insurance for major diseases for security keyAdvice shall, in vast rural areas, by city and county as the unit first to establish farmer major disease insurance. Farmer major disease insurance funding sources, mainly take the farmers financing and fiscal subsidy method, combining the investment proportion can adjust measures to local conditions, starting from the actual situation around. Compared with the traditional cooperative medical care system, farmer major diseaseinsurance is characterized by a high level as a whole, strong ability to resist risks, financing level is low, easy to raise, management and settlement etc. In addition, can also be in conditional area farmers, on the basis of major disease insurance, developing more comprehensive health care.3.4 Establish medical assistance system, the strengthening of health poverty alleviation workConstruction and effective operation of the public health service system, the implementation of prevention and the principle of using low cost effective medical technology and is likely to ensure that everyone will have access to basic health care services, but it is impossible to completely prevent the poverty due to illness, Chinese phenomenon happened due to illness, therefore the poor region, poor health poverty alleviation as one of the important content of rural health care work. The traditional economic and health organically for poverty alleviation, by the central government and support of developed areas, first of all solve the problem of health facilities construction in the poor areas and underserved, and in the state poverty relief funds and relevant support fund fraction, solve the problems of health poverty alleviation in poor areas. To conform to the conditions of the rural poor, to medical assistance scheme, so as to perfect the rural medical security system.3.5 Strengthen propaganda, to guide peasants to voluntary contribution to attend cooperative medical treatmentFarmers voluntary contribution, participants in the cooperative medical care system is the foundation of the rural cooperative medical system is able to push for a long time. Therefore, to vigorously promote cooperative medical significance, the embodiment of the propaganda occurs around the rural residents in the typical example of new cooperative medical care system superiority, makes the new cooperative medical system is deeply rooted in the hearts of the people; Through publicity and education, make the farmers understand national reconstruction of cooperative medical care system determination and funding for state finance on rural cooperative medical care system and practical experience to participate in cooperative medical benefits and benefits, so as to improve the enthusiasm of participation.。