Pilot Programme of China’s New Cooperative Medical Scheme System Design and Progress

collapsed as the country’s economic system moved from following a planned economy model to a socialist market model. The CMS was funded by village collectives and farmers, managed by barefoot doctors and/or farmers and its risk pooling was established at village or township levels. Between 1991 and 2003, out-of-pocket expenditure on health services increased significantly, rising from 105.7 % to 149.1% of farmers ’ net income per capita. Furthermore, until 2003, 45.8 % of persons who were ill did not see physicians and 80 % of rural residents had no health security. In addition, 30.3 % of patients who were required to be hospitalized following the recommendations of doctors could not afford to go to hospital. Given the prevailing circumstances, setting up a health security system for farmers was a high priority at the national level. At the end of 2002, the Central Government took a decision to establish a New Cooperative Medical Scheme (NCMS) in rural areas to provide farmers with health security. Pilot programmes of the NCMS have been implemented since 2003 in 620 counties (or county-level cities), and 165 million farmers are covered by the scheme, as per the guidelines approved by the Centra