新型农村合作医疗制度设计初衷在于让贫困农民家庭能够看得起病,提高农村的社会保障水平。但实际操作中,在参合费用不断上涨的情况下,那些最为贫困的家庭恰好倾向于选择不参合新型农村合作医疗。应用统计数据和质性资料说明在研究个案中:贫困农民家庭的收入水平与参合新型农村合作医疗的意愿呈正相关关系。引进“累进制”的资金管理和使用办法可以有效提高贫困农民家庭的参合意愿。 The original design of the new rural cooperative medical system was designed to enable families of poor peasants to see the sick and improve the level of social security in rural areas. However, in the actual operation, with the rising cost of participation, those who are most impoverished tend to choose not to participate in the new rural cooperative medical system. Application statistics and qualitative data indicate that in the study case, the income level of poor peasant households is positively related to their willingness to participate in the new rural cooperative medical care. The introduction of “progressive” fund management and use of methods can effectively improve the willingness of poor farmers participation.