Great changes have taken place since collective economy system collapsed after economic reforms in rural China, exerting tremendous influence on the structure of financing and ways of operation of CMS.

• 随着以家庭为生产单元的家庭联产承包责任制取代了集体经济，改革前后的农村经济体制发生了巨大变化，这对合作医疗的筹资结构和运作方式产生了重大影响，使两个时期的合作医疗呈现出不同的特点和明显的差别。