此書稿得以付梓，係我的導師關信平教授給予我悉心的教誨和指導。早在20年前，關教授就指導我的畢業實習和畢業論文，親手把我引入了社會學、社會政策學的殿堂。在讀博士的5年期間，關教授又為我付出了很多。回想起來，如果沒有導師的悉心教導，我可能沒有毅力克服學習中的困難並不斷取得進步。
在學習期間，南開大學社會學係的侯均生教授、樂國安教授、王處輝教授、劉珺珺教授、趙萬裏教授等老師，有的是傳道、授業、解惑的老師，有的是麵提耳訓的長者，他們給我創造了學習的機會和給予了寶貴的指導。
我的學友徐道穩博士、鄭飛北博士等也在我的日常學習、論文寫作過程中給予了很大的支持與幫助。
湖南省政協副主席、長沙民政職業技術學院院長劉曉教授在2003年新型農村合作醫療試點剛剛啟動時就帶我進行了第一次工作考察，促使我最終選擇了新型農村合作醫療這一研究課題，以後他又在研究中給予我各方麵的指導。
這幾年，民政部低保司朱勇生司長、柳拯副司長、劉喜堂處長，以及我的同事劉昌平和李永強等老師，都在資料的收集、整理，以及研究櫃架的形成等方麵，給予了我大力支持。
本書的下編是湖南省社科基金研究課題。在課題研究過程中，湖南省社科規劃辦、湖南省民政廳低保處，以及參與課題研究的同誌們都給予了我支持和幫助。
我的妻子、兒子對我的學習、研究給予了重要的支持，使我得以靜下心來學習與研究。
在此，對以上給予我支持與幫助的導師、領導、學友表示誠摯的謝意！
農村新型醫療保障政策在農村實施的時間尚短，因為資料和研究時間的局限，另外，本人的研究能力仍待進一步提高，故本書難免存在不足，懇請讀者指出。
鄒文開
2007年11月1日
Abstract
This paper is composed of five parts. Part I is the introduction, which covers the research object, basic concepts, research framework, methodology, and the significance of this study. Here a great emphasis is placed on the research object. Part II explores the reason why government choose the new rural cooperative medical scheme(RCMS) as a policy alternative. In this part, the development of traditional RCMS is examined historically, and an in-depth comparison of various medical systems across the world is conducted. This part also discusses the reality that rural residents find it difficult for them to gain access to or afford the medical services. Part III presents a general picture of the new RCMS. It sketches the experience and achievements of pilot projects of the new RCMS, and reports the survey conducted in a certain pilot project. Part IV analyzes the main problems regarding new RCMS, particularly the problems of financing by individual contribution, of public administration, and of service provision by medical institutions. It should be noted that the researcher approaches these issues from the perspectives of institutional design, of background, and of opportunistic behavior. Part V projects the development of the new RCMS in the future, and puts forward several policy suggestions indispensable for its success.
This paper aims to provide an in-depth analysis of the running of the new RCMS, as well as the opportunistic behavior of its key actors. As to the analytical framework, this paper is problem-oriented. It first analyses the context within which the government choose the new RCMS as a policy alternative so as to illustrate the rationality of this choice. Then, it describes the running of the new RCMS with a view to illuminating the three problems, i.e., the problem of financing, of public administration, and of cheap medical services. In what follows, it explores the origins and effects of these afore-mentioned problems from the perspective of institutions, background, and opportunistic behavior. Finally, it puts forward what policies could be taken to address these problems.
In examining the effects of the new RCMS and the opportunistic behavior of policy actors, this paper argues that: