Pilot Program of New Cooperative Medical Schemes (NCMS) in China : System design and progress

Pilot Program of NCMS in China: System design and progress Final draft, October, 2005 This paper was prepared by Mao Zhengzhong, Sichuan University as a background paper for the World Bank China Rural Health Study. The findings, interpretations and conclusions expressed in this paper are entirely those of the authors, and do not necessarily represent the views of the World Bank, its Executive Directors, or the countries they represent. 1  I. Introduction Pilot programs of New Cooperative Medical Schemes (NCMS) have been implemented for a year or longer in 310 counties (or county-level cities) till the end of 2004, according to the series of stipulations of the Central Committee of CCP and State Council. There have been another 306 counties implementing the pilot program beginning since the beginning of 2005. Thus, about one third of the counties in the country have been implementing the pilot program. Based on the statistics from 282 pilot counties, survey data of our own research, as well as NCMS-related literature since 2003, this report aims to offer a brief introduction of the program in terms of systematic characteristics, implementing condition, experience, issues and challenges, so as to provide information to perfect NCMS policy and improve the pilot implementing. .NCMS System Design 1. Documents of the central government have clear stipulations on the system design of NCMS [1-4], which can be summarized as following: (1) Nature of NCMS NCMS is a government organized and conducted scheme of mutual assistance among voluntary participating farmers against serious diseases. It makes use of multiple channels diverse funding sources from personal payment, government and collective subsidy, donation and so on. The goal is to protect farmers from becoming or returning poverty-stricken because of catastrophic illness including infectious diseases and endemic diseases. It can be called a primary medical security system for rural population. But the ultimate liability is still not certain. For example, we are not sure who would be responsible for the "bankruptcy" of the fund. 2