今年是新型农村合作医疗制度10周年。2002年10月，党中央国务院决定，在全国建立新型农村合作医疗制度。2003年，新农合制度试点在全国陆续展开。10年间，新农合制度从低水平起步，逐渐成熟和完善，取得了令世界瞩目的巨大成就，为我国建立全民基本医疗保障制度奠定了坚实基础。

This year is the new rural cooperative medical care system 10 anniversary。October 2002，The party central committee decision of the state council，In the whole nation builds new rural cooperative medical system。2003 years，New farming system in the country and pilot in an。10 years，New farming from the low level and system started，The increasingly mature and perfect，The attention of the world has made great achievement，For the establishment of China's national basic medical insurance system laid solid foundation。

　　为了纪念这一重大历史事件，本版从即日起推出“新农合制度十年观察”系列报道，敬请关注。

To commemorate this great historical events，This version from now onwards, launched“New farming system and ten years observation”Series of reports，Please pay attention。

　　——编者

-editor

　　

1.一个名字见证一项制度 1. A name witness a system

　　中国人的名字，常常与某些重大历史事件联在一起。魏新合，一个普通四川农村女孩，就是新农合制度的见证者。

Chinese name，Often with some great historical events bound together。WeiXin $，A common sichuan rural girl，Is the new agriculture and system of witnesses。

　　2006年1月1日，四川省剑阁县剑门关镇风垭村农民王海芳，来到剑门关镇中心卫生院做产前检查。为了省钱，她准备回家生孩子。然而，医生告诉她，只要参加了新农合，住院分娩可以补偿100元。于是，她立即办理了手续。次日凌晨，顺利产下一名女婴。这是剑阁县启动新农合制度后的第一例新生儿。

On January 1, 2006，Sichuan province JianGeXian sword door closed by the same WangHaiFang wind，Came to the door shut the town center sword hospital do antenatal examination。In order to save money，Her children to prepare to go home。however，The doctor told her，As long as the new farming to close，Inpatient delivery can compensate for 100 yuan。so，She immediately deal with formalities。The morning，Given birth to a baby girl。This is JianGeXian start new farming system and after the first example of a new baby。

　　当年1月2日，县卫生局长一行来到病房看望她。王海芳的公公魏在烈是位老实巴交的农民，他一直在纳闷：生了个娃，住院费花了370元，为什么还要补100元？局长一解释，他才恍然大悟。老人说：“新农合是个好政策，我想给孩子起个有纪念意义的名字，就叫魏新合吧。”

That year on January 2,，County public health director a line came to see her ward。WangHaiFang father-in-law WeiZaiLie is a LaoShiBaJiao farmers，He has been in wonder：Had a doll，Hospitalization cost 370 yuan，Why fill 100 yuan？Chief interpretation，He is suddenly enlighted。The old man said：“New farming and is a good policy，I want to give children a commemoration of the name，Call WeiXin close it。”

　　今年5月，记者重访剑阁县，见到魏新合一家人。王海芳告诉记者：“现在农村生小孩全免费了，那时虽说只补了100元，但农民看病政府拿钱，还是破天荒头一次。”魏在烈说：“我听说现在镇上有人生大病，居然报了十几万，这在过去是做梦也想不到的。”

In may this year，Reporter JianGeXian glorious，See WeiXin family unity。WangHaiFang told reporters：“Now the whole free children......，Although only then up the 100 yuan，But farmers government take money to see a doctor，Or has a head。”WeiZaiLie said：“I hear that now town has life a serious illness，Incredibly called the several hundred thousand，This is in the past has ever dreamed of。”

　　如今，魏新合已经6岁了，在剑门关小学幼儿园上学前班。最近，父母给她改名为“魏偲媛”，取“饮水思源”之意。

now，WeiXin close already 6 years old，On the door closed primary school kindergarten preschool。recent，Parents give her name to“W Cai gentle”，take“April showers bring may flowers”The meaning of the。

　　魏新合的故事，是新农合制度的一个缩影。

WeiXin $story，New farm is a miniature of the close system。

　　2008年，全国参加新农合人口突破8亿。2011年，全国参加新农合的人口达到8.32亿，参合率达到97%。新农合制度首次将所有农民全部纳入基本医疗保障制度的覆盖范围，使农民看病告别了“全自费时代”。目前，新农合制度成为世界上覆盖人口最多的基本医疗保障制度，也是具有中国特色的农村居民健康保障制度。

2008 years，In the new farm population hit $800 million。2011 years，The new farm together in a population of 832 million，Ginseng add up to rate reached 97%。New farming system and for the first time all farmers, all included in the basic medical insurance system coverage，Farmers say goodbye to see a doctor“At all times”。At present，New farming system and become the world's most populous covering basic medical security system，Also is to have Chinese characteristics of rural residents health security system。

　　“新农合制度为后续推行的其他社会保障制度如城镇居民医保、新型农村养老保险提供了借鉴，也为全民医保制度的建立奠定了基础。新农合制度成为我国非正式就业居民社会保障体系的‘设计原型’，为推进社会领域改革积累了宝贵的制度经验。”农业部农村政策研究中心研究员蒋中一说。

“New farming system and for the follow-up of carrying out the other social security system such as medical insurance for urban residents、A new type of rural endowment insurance provides reference，Also for the establishment of the medical insurance system to lay the foundation。New farming and system become China's informal employment residents of the social security system‘Design prototype’，To promote social reform field accumulated valuable experience system。”Department of agriculture rural policy research center in jiang researchers said Monday。

　　

2.政府承担主要筹资责任 2. The government assumes the main financing responsibility

　　“小病拖，大病扛，实在不行见阎王。”这曾是我国农民的真实写照。

“Ailment pulls，Carried a serious illness，It can't see yan the king。”This was the real portraiture of Chinese farmers。

　　2003年第三次国家卫生服务调查显示，全国有45.8%的患病农民应就诊而未就诊，30.3%的患病农民应住院而未住院，主要原因是经济困难。

In 2003 the third national health services survey，45.8% of the nation should be sick doctor and did not seek farmers，30.3% of farmers should be in hospital but not sick in hospital，The main reason is the economic difficulties。

　　20世纪五六十年代，我国把传统合作医疗作为解决农民健康问题的一项重要措施。农民与乡村集体共同出资，通过互助共济来解决“小伤小病”等健康问题。

20 century s to s，The traditional cooperative medical treatment in China for solving the problem of farmers' health is an important measures。Farmers and the rural collective joint contribution，Through the help each other in all aid to solve“Minor injury ailment”Health problems such as。

　　20世纪80年代，由于集体经济逐渐解体，加上筹资水平低、制度本身存在缺陷，传统合作医疗开始出现大面积滑坡，农民看病只能依靠自费，城乡居民健康差距扩大。

The 1980 s，Due to the collective economic disintegrating，Plus funding level is low、System itself, there are defects，Traditional cooperative medical began to a massive landslide，Farmers a doctor can only rely on the expenses，Urban and rural residents health gap。

　　20世纪90年代，政府提出了“恢复和重建”合作医疗制度。但是，大部分试点无果而终。主要原因是，政府坚持“筹资以个人为主，集体扶持，政府适当支持”。实际上，相当多的县乡财政是“吃饭财政”，难以支持农民医疗保障；乡村集体经济脆弱，无力扶持农民医疗保障。结果，担子最后还是压在了农民自己肩上，农民戏称是“春办秋黄”。到1998年，传统合作医疗覆盖农村人口比重只有6.57%，而且水平很低，绝大多数农民没有任何医疗保障。

The 1990 s，The government put forward“Recovery and reconstruction”Cooperative medical system。but，Most of the pilot goes sour。The main reason is，The government insisted“Personal financing to give priority to，Collective support，Government suitable support”。In fact，Quite a number of county and township government finance is“Eat financial”，Difficult to support the farmers' health care；Rural collective economy vulnerable，Unable to support farmers health insurance。The results，Finally on the burden of farmers his shoulder，Farmers called is“Spring autumn yellow do”。By 1998，Traditional cooperative medical cover rural population is only 6.57%，And level is very low，Most farmers don't have any health insurance。

　　吸取两起两落的教训， 2002年10月，我国提出建立新型农村合作医疗制度。

Draw up two of the teaching of the two falls， October 2002，Our country puts forward to building new rural cooperative medical system。

　　与传统合作医疗比较，新农合制度具有以下特点：一是筹资以政府补助为主；二是农民以家庭为单位自愿参加；三是以县为单位统筹基金管理；四是以大病报销为主；五是同步推进农村医疗救助制度。

Compared with the traditional cooperative medical treatment，New farming and system has the following features：A government subsidy is financing to give priority to；2 it is the farmers to families voluntarily participate in the unit；Three is to plan as a whole fund management unit county；Four is a serious illness to submit an expense account to give priority to；Five is synchronized advancement rural medical treatment system。

　　2003年，各级政府对新农合的人均补助标准为20元，农民每人缴纳10元，人均筹资标准仅为30元。在历史上，这是政府第一次为解决农民的基本医疗问题而承担直接筹资责任。

2003 years，Governments at all levels to new farming $per capita subsidies standards for 20 yuan，Farmers pay $10 per person，Per capita is only 30 yuan financing standard。In the history，This is the first time the government to solve the farmer's basic medical problems and assume direct financing responsibility。

　　“30元就能解决农民的看病问题？当时，很多人都抱着怀疑的态度。由于新农合的‘蛋糕’太小，很多人都认为难成气候，甚至当成笑话。”卫生部新农合研究中心常务副主任汪早立说。

“30 yuan can solve the problem of farmers to see a doctor？At that time，Many people hold skeptical。Because of the close new farming‘cake’Is too small，Many people think that it is difficult ChengQiHou，Even as jokes。”The health ministry new farming and research center, executive deputy director wang early made said。

　　然而，新农合制度的生命力似乎超过了常人的想象力。目前，新农合基金的80%是由政府投入，财政资金已成为新农合基金的主要来源。2011年，各级政府对新农合的人均补助标准提高到200元，农民每人交纳50元，新农合筹资标准达到250元左右。2012年，各级政府对新农合的人均补助标准将提高到240元，新农合筹资标准达到290元。

however，New farming system and the vitality of more than ordinary people seem to imagination。At present，New farming and 80% of the fund is by government investment，Financial capital has become a new farming and the main source of funds。2011 years，Governments at all levels to new farming $per capita subsidies standards have been raised to 200 yuan，Farmers pay 50 yuan per person，New farming and to raise the standard 250 yuan。2012 years，Governments at all levels to new farming $per capita subsidies standards will improve to 240 yuan，New farming and financing standard to 290 yuan。

　　“十年来，新农合制度之所以蓬勃发展，一个重要原因就是坚持农民自愿参加，尊重农民意愿，真正做到为民、利民、便民。”汪早立说。

“Ten years，New farming system and the vigorous development，One important reason is to stick to farmers volunteered to join，Respect the wishes of farmers，People really do、out、Convenience for the people。”Wang made said earlier。

　　

3.重点减轻重大疾病负担 3. Key reduce major disease burden

　　在河南省胸科医院，记者见到一名4个月大的男孩，河南淮阳县许湾乡郭庄村人。他一出生就嘴唇发紫，因患肺炎住院，医生发现是先天性心脏病，医学上叫“室间隔缺损”。父亲郭明明在深圳打工，一年只能赚一万多元，而孩子的手术费需要三四万元。今年3月，他听说新农合对儿童先天性心脏病手术有优惠政策，于是带孩子来到这家定点医院。

Thoracic hospital in henan province，The reporter saw a 4 months old boy，Henan HuaiYangXian XuWan township GuoZhuang village。He was born purple lips，Because suffer from pneumonia in hospital，The doctor found is congenital heart disease，Medicine that“Ventricular septal defect”。Father GuoMingMing work in shenzhen，A year can earn ten thousand multivariate，And the child's operation need three or four ten thousand yuan。In march this year，He heard that new farming to children with congenital heart disease have surgery preferential policies，So with the children came to the designated hospital。

　　由于参加了新农合，孩子住院只需交3500元押金。此次医疗费共计3.5万元，自费为3500元。看着孩子红扑扑的脸，郭明明欣喜地说：“真没想到，做这么大的心脏手术，才花几千元，新农合政策太好了！”

Because the new farming to close，Children in hospital in only 3500 yuan deposit。The medical treatment cost a total of 35000 yuan，At one's own expenses for 3500 yuan。Look at children red face，GuoMingMing was delighted to said：“I didn't know that，Do so big of the heart operation，To spend thousands of dollars，New farming and policy too good！”

　　根据河南省的规定，农村儿童患急性白血病、先天性心脏病两大类疾病6个病种，新农合补偿70%，医疗救助补偿20%，患儿住院只需交纳住院费用的10%。同时，河南省参合农民在省内所有定点医院看病，都可以享受即时结报政策。出院时，患者只需结清个人自付部分医疗费用，新农合补偿费用由定点医院垫付。

According to the provisions of henan province，Rural children with acute leukemia、Congenital heart disease two kinds big disease six diseases，New farming and compensation of 70%，Medical treatment compensation of 20%，Children need to hand in charge of be in hospital of 10%。At the same time，Henan farmers in the province all ginseng add up to nod a hospital，All can enjoy instant "quote policy。discharge，Patients just settlement since pay medical treatment cost of individuals，New farming and compensation fees paid by the hospital。

　　2010年，我国启动农村儿童先天性心脏病、急性白血病等两类重大疾病医疗保障试点，2011年以省为单位全面推开。2011年，国家将终末期肾病等6类新增疾病纳入重大疾病保障试点。截至2011年底，累计有超过23万8类重大疾病患者受益，其中有近3万名先心病患儿康复。

2010 years，Our country rural start of congenital heart disease in children、Acute leukemia and two kinds of major disease medical security pilot，2011 years to save for full implementation of the unit。2011 years，Countries will end-stage renal disease six kinds of new diseases into major disease security pilot。By the end of 2011，Accumulative total more than 230000 eight major disease patients benefit，There are nearly 30000 congenital heart disease patients recover。

　　从2003年以来，全国累计已有42亿人次享受新农合基金补偿，共补偿资金4500亿元。2011年，新农合政策范围内住院医药费用补偿比例达到70%，农民住院实际报销比例超过50%。根据国务院要求，2012年新农合政策范围内住院医药费用补偿比例达到75%，最高支付限额不低于农村居民人均纯收入的8倍且不低于6万元。

Since 2003，A total of 4.2 billion people enjoy new farming has close fund compensation，Total compensation fund 450 billion yuan。2011 years，New farming and policy in hospital medical expenses within the scope of compensation to 70%，Farmers in hospital to submit an expense account actual more than 50%。According to the state council requirements，In 2012 the new agriculture and policy in hospital medical expenses within the scope of compensation to 75%，Highest pay limitation is not less than the per capita net income of rural residents 8 times and not less than 60000 yuan。

　　据卫生部统计，参合农民住院个人需要承担的部分占年纯收入的比例，从2003年的107%下降到2011年的30%左右。很多患重病农民得到及时救治，避免了因病致贫、因病返贫的悲剧。

According to the health ministry statistics，Ginseng add up to farmers need to take part in the personal accounts for years the proportion of net income，From 107% in 2003 to 30% in 2011 or so。Many farmers get timely treatment with seriously，Avoid become financially-difficult or、The tragedy of poverty due to illness。

　　

4.差别化筹资优于“一刀切” 4. Better than menas financing“One size fits all”

　　“如何建立长期稳定的筹资机制，是当前新农合制度面临的最突出问题之一。”卫生部农村卫生管理司副司长聂春雷说。

“How to establish long-term stable fund-raising mechanism，Is the current new farming system and one of the most outstanding problems facing。”The health ministry of rural health management department chief of NieChunLei said。

　　从新农合制度建立至今，政府不断提高新农合筹资水平。从人均筹资30元到290元，实现了快速增长。但目前筹资模式的两个重要特征——定额增长和固定筹资，显示了筹资机制还尚待完善。

Since the establishment of the new agriculture and system，The government improve new farming and funding level。Per capita financing from 30 yuan to 290 yuan，Realize the fast growth。But now the contribution model the two important features of fixed growth and fixed-raise money，Show the fund-raising mechanism still is yet to be perfected。

　　定额增长的做法影响了各级财政预算的及时安排和新农合筹资环节的管理。“一刀切”的筹资标准，与不同经济地区的地方财政能力、农民缴费能力以及医疗消费水平不相适应，也不符合筹资公平性的要求。以2011年人均50元参合缴费为例，这一标准占农民人均纯收入的比重，在西部省份大多超过了1%，而在中部省份只有0.7%，说明农民缴费负荷已经有明显差别。

Norm of the practice of the affected the growth at all levels of the budget in time and new farming and financing link management。“One size fits all”Fund-raising standard，And different economic area of local financial ability、Farmers pay cost ability and medical consumption level does not adapt，Do not conform to the requirements of the equity financing。In 2011, the per capita $50 ginseng add up to pay cost, for example，The standard of the proportion of per capita net income of farmers，In most western provinces more than 1%，And in the central province of only 0.7%，Farmers pay cost that load has significant difference。

　　卫生部卫生发展研究中心研究员应亚珍认为，从新农合发展历程分析，在筹资水平很低的情况下，实行统一的筹资政策和筹资标准，既是可行的，也是必要的。但是，新农合作为一项基本医疗保险制度，人均筹资水平已经从最初的占农村居民家庭人均纯收入的1%，增加到了现在的3.5%以上。因此，从制度的可持续发展考虑，有必要基于各方筹资缴费能力和不同地区医疗消费状况，逐步构建差别化筹资机制。

Health and development research center should be and Jane think researcher，With the new agriculture development process analysis，In the funding level is very low，A unified financing policies and financing standards，Is feasible，Also is necessary。but，The new agriculture cooperation for a system of insurance of primary medical treatment，Per capita funding level has from the per capita net income of rural households accounted for 1%，Increased to 3.5% now above。so，The sustainable development of the system from consideration，Necessary parties based on financing ability and different regions expends medical consumption，Gradually construct differentiation financing mechanism。

　　按照国际惯例，医保筹资应与居民人均收入水平挂钩，不同人群承担与其收入水平相适应的参保缴费，但享受同等的保障待遇，以充分体现制度的公平性。

According to international practice，Health care financing should be and residents' per capita income skill，Different populations and adapt to undertake the income level the ginseng of pay cost，But enjoy the same to ensure treatment，To fully embody the fairness of the system。

　　应亚珍建议，新农合筹资水平应与农村居民家庭人均纯收入挂钩。可参照城镇职工基本医疗保险的筹资水平(职工工资的8%)，逐步实现新农合人均筹资占农村居民家庭人均纯收入8%的目标。在“十二五”期间，这一比重尽可能达到5%—6%。同时，要科学划分各级财政与农民之间的筹资责任。其中，各级财政补助占总筹资的平均比例应不低于75%，中西部财政筹资比例应超过80%。就差别化筹资的总体格局而言，以中央统一要求新农合人均筹资占农村居民家庭人均纯收入的比重为基础，中央财政与省级财政继续按现有模式承担筹资责任，不同地区筹资额度的差别主要体现在农民缴费和县级财政补助上。

Should and Jane Suggestions，New farming and funding level should with per capita net income of rural households hook。We can refer to town worker is basic medical insurance of the funding level(Worker pay by 8%)，Gradually realize new farming $per capita financing rural residents per capita net income of family's target of 8%。in“1025”during，The rate as 5%-6%。At the same time，To scientifically differentiate among farmers at all levels for finance and the financing responsibility。Among them，Financial aid at all levels to total financing for the average ratio should not be less than 75%，The Midwest financial financing should be more than 80% proportion。The general pattern of financing is differentiation is concerned，With the central united requirements new farming $per capita of financing rural households the proportion of per capita net income for the foundation，The central government and the provincial public finance to continue to do the existing model for financing responsibility，Different regions financing limit of difference is mainly embodied in the farmer pay cost and the financial aid。

　　聂春雷认为，由于中国社会经济“二元化”的特征，农村经济发展水平和农民收入水平总体较低，加之经济欠发达地区农民的货币收入较少，政府承担主要的筹资责任有利于新农合制度的持续运行，也有利于城乡社会经济的协调发展。

NieChunLei think，Because of China's social economy“between”features，Rural economic development level and farmer income levels are generally low，Together with undeveloped areas of farmers earn less money，The government assumes the main responsibility to raise new farming and continued operation of the system，But also to the coordinated development of urban and rural social economy。