Contrastación de hipótesis Hipótesis general

The new RCMS is both a policy and a program of the State Council of China’s Central Government. The administrative system of the new RCMS is under the guidance of the Government. The Public Health Department, which is headed by the Coordinator, is in charge. Routine work is carried out by the office staff, and the medical services are provided through various levels of hospitals. Monitoring, evaluation and technical support are carried out by relevant staff members.

The next level of administration is the province, with one Rural Health Affairs Administration Office located in each provincial Health Bureau. The scheme is further organised by city and county (or regional area), both of which accommodate RCMS headquarters. There are numerous cities in each province, with one RCMS office located in each city Health Bureau. The city often serves as a centre for many counties belonging to it. In each county, there are numerous towns, each of which has a RCMS office. The town often serves as a centre for many villages. At the individual village level there are no paid RCMS agencies but there are usually village leaders who communicate between the RCMS township office and the villagers.

Older Miao People and Rural Health Policy in China Lin Yuan, University of Sydney, 2012

National level

The Uniting Conference of the State Council is the organisation charged with responsibility to correspond on behalf of the new RCMS, to undertake macro-level steering, to monitor the implementation of RCMS policies and to monitor and evaluate the pilot program. The Ministry of Public Health is in charge of the work undertaken by the new RCMS. The Research Centre of the Public Health Ministry has overall responsibility for both management and research. The Centre’s managerial responsibilities include supervision, inspection and evaluation, operational guidance and training, information management, inquiries, complaints and inspection, investigation and research, reporting on promotion of the new RCMS in rural China, as well as scientific research, international exchanges and cooperation. The Technical Steering Group of the Public Health Ministry also assists with research, including pilot projects, for each province, as well as undertaking theoretical research and public health official training, and to suggest problem-solving measures related to the new RCMS implementation as well as to improve the new RCMS policies.

Provincial and area level

The provincial and area governments have Coordinator Groups. These include Public Health, Finance, Agriculture, Civil Administration, Reform and Development, Audits, Supervising Foodstuffs and Medical Materials, Traditional Chinese Medicine, and Helping the Poor, among others. The Office of the Coordinator Groups is located in the Public Health Department, and has responsibility for day-to-day work.

Older Miao People and Rural Health Policy in China Lin Yuan, University of Sydney, 2012

County level

The new RCMS Supervisory Committee was established in county government. It comprises the leaders from relevant departments and townships and the deputy directors of the rural residents’ committees (who are also participants in the new RCMS). Under the Supervisory Committee, an administrative office takes charge of routine affairs. They assess reimbursement rates for inpatients and outpatients according to the Scheme’s budget and medical costs, verify applications for RCMS reimbursement and establish detailed criteria for reimbursement of medicines and medical procedures. These criteria vary in different counties. The richer counties, the higher the reimbursement rates are. The new RCMS encourage rural agricultural workers to solve their health issues closed by. The total trend of reimbursement rate is that rural workers can obtain more medical cost reimbursement (around 60 per cent of their medical cost) from their township hospitals while they get less ones if they approach county and higher level hospitals. The Public Health Department’s administrative office takes charge of the medical service. In recent years, some counties have moved the administration of the RCMS to China’s social security portfolio.

Premium levels and reimbursement rates vary from county to county, with higher levels and rates in the richer counties. The new RCMS encourages rural agricultural workers to seek health care in their local area. Accordingly, they receive a higher

Older Miao People and Rural Health Policy in China Lin Yuan, University of Sydney, 2012

level of reimbursement (around 60 per cent of their medical costs) for treatment at their township hospitals than at county level hospitals or above.

Township and village level

Townships are under the jurisdiction of the counties in their management of the RCMS. The township government may establish a Supervisory Committee with the leader of the township government as the director. The committee also includes the leaders of the relevant departments, the directors of rural resident committees and their deputies.

Rural town administrators are responsible for a number of tasks associated with implementing and managing the new RCMS. They keep records of people enrolled in the scheme, process applications for reimbursement of fees paid by patients, and consult with health professionals, village leaders, and the people themselves about their experience with the new RCMS.

In villages, the rural residents’ committee director can become the group leader, and the members and the deputies of the rural residents’ committees will make up the Supervisory Group. Its responsibilities include publicising the new RCMS, mobilising rural residents to participate in it, assisting with fee collection, and publishing detailed financial records.

Older Miao People and Rural Health Policy in China Lin Yuan, University of Sydney, 2012

According to requirements or need, a county administrative office may be established (or personnel dispatched), or they may commission an organisation to be in charge, to assist in the mobilisation of rural residents participating in the new RCMS, and also to assist with the collection of fees.