我国商业健康保险参保对家庭贫困发生率的影响及其异质性研究

李建国; 林玲

doi:10.19546/j.issn.1674-3830.2023.7.015

中国医疗保险 ›› 2023, Vol. 0 ›› Issue (7) : 111-119. DOI: 10.19546/j.issn.1674-3830.2023.7.015

李建国, 林玲

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Study on the Effect and Heterogeneity of Commercial Health Insurance Participation on the Incidence of Household Poverty in China

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摘要

目的: 分析我国商业健康保险参保对家庭贫困发生率的影响及其异质性。方法: 利用2018年CHARLS数据,通过Logistic和PSM模型进行分析。结果: 商业健康保险参保可使家庭绝对和相对贫困发生率分别降低6.2和8.9个百分点。运用PSM控制样本选择性偏误后,家庭绝对和相对贫困发生率显著降低7.4和8.8个百分点。商业健康保险参保可使农村家庭组、老年家庭组、健康一般家庭组绝对贫困发生率分别下降8.2、13.3、8.9个百分点,相对贫困发生率分别下降12.0、15.6、12.7个百分点,可使得健康较差家庭组绝对贫困发生率显著下降16.1个百分点,对其他样本组影响不显著。结论: 我国商业健康保险覆盖率较低,商业健康保险参保能够显著降低家庭贫困发生率,研究结果具有稳健性。商业健康保险参保对家庭贫困发生率的影响存在城乡家庭组、不同年龄家庭组和不同自评健康家庭组差异,具有很强的异质性。建议: 扩大商业健康保险覆盖面,加强对农村地区、老年家庭、户主自评健康状况较差家庭的商业健康保险参保支持力度,更大发挥商业健康保险的反贫困功能。

Abstract

Objective: The paper analyzes the effect and heterogeneity of commercial health insurance participation on the incidence of household poverty in China. Methods: The paper uses the data of China Health and Retirement Longitudinal Study in 2018, based on Logistic and propensity score matching (PSM) models. Results: Participation in commercial health insurance can reduce the incidence of absolute and relative household poverty by 6.2 and 8.9 percentage points, respectively. Using PSM to control for sample selectivity bias, the incidence of absolute and relative poverty was significantly reduced by 7.4 and 8.8 percentage points. The participation of commercial health insurance can reduce the incidence of absolute poverty in rural family groups, elderly family groups and the family groups with general health by 8.2, 13.3 and 8.9 percentage points respectively, the incidence of relative poverty dropped by 12.0, 15.6 and 12.7 percentage points respectively, also it can significantly reduce the incidence of absolute poverty of the family groups with poor health by 16.1 percentage points. The effect on other sample groups was not significant. Conclusion: The coverage rate of commercial health insurance is low in China. Participation in commercial health insurance can significantly reduce the incidence of household poverty. The results are robust. The effects of commercial health insurance on the incidence of household poverty are different among urban and rural family groups, family groups with different ages and family groups with different self-rated health status, which has strong heterogeneity. Suggestions: The coverage of commercial health insurance should be expanded. The support for the participation of commercial health insurance in rural areas, elderly families, and families with poor self-rated health status should be strengthened to give full play to the anti-poverty function of commercial health insurance.

导出引用

李建国, 林玲. 我国商业健康保险参保对家庭贫困发生率的影响及其异质性研究[J]. 中国医疗保险. 2023, 0(7): 111-119 https://doi.org/10.19546/j.issn.1674-3830.2023.7.015

Study on the Effect and Heterogeneity of Commercial Health Insurance Participation on the Incidence of Household Poverty in China[J]. China Health Insurance. 2023, 0(7): 111-119 https://doi.org/10.19546/j.issn.1674-3830.2023.7.015

中图分类号： F840.684C913.7

参考文献

[1] RAIMUND M KOVACEVIC, GEORG CH PFLUG.Does Insurance Help to Escape the Poverty Trap?--A Ruin Theoretic Approach[J].The Journal of Risk and Insurance,2011,78(4):1003-1027.
[2] JUNG HYUN WOO, KWON YOUNG DAE, NOH JIN WON.How public and private health insurance coverage mitigates catastrophic health expenditures in Republic of Korea[J].BMC Health Services Research,2022,22(1):1042.
[3] BERNARD DIDEM M, BANTHIN JESSICA S, ENCINOSA WILLIAM E.Health care expenditure burdens among adults with diabetes in 2001[J].Medical care,2006,44(3):210-215.
[4] SANDERS D.KORENMAN, DAHLIA K.REMLER.Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty[J].Journal of Health Economics,2016,50:27-35.
[5] REMLER DAHLIA K, KORENMAN SANDERS D, HYSON ROSEMARY T.Estimating The Effects Of Health Insurance And Other Social Programs On Poverty Under The Affordable Care Act[J].Health affairs (Project Hope),2017,36(10):1828-1837.
[6] SYED ABDUL HAMID, JENNIFER ROBERTS, PAUL MOSLEY.Can Micro Health Insurance Reduce Poverty? Evidence From Bangladesh[J].The Journal of Risk and Insurance,2011,78(1):57-82.
[7] SHIFA SALMAN HABIB, SHAGUFTA PERVEEN, HUSSAIN MAQBOOL AHMED KHUWAJA.The role of micro health insurance in providing financial risk protection in developing countries- a systematic review[J].BMC Public Health,2016,16(1):281.
[8] 潘国臣,李雪.基于可持续生计框架(SLA)的脱贫风险分析与保险扶贫[J].保险研究,2016(10):71-80.
[9] 蒋和胜,李小瑜,田永.阻断返贫的长效机制研究[J].吉林大学社会科学学报,2020,60(06):24-34+231-232.
[10] 朱铭来,奎潮.医疗保障对居民消费水平的影响——基于省级面板数据的实证研究[J].保险研究,2012(04):103-111.
[11] 吴庆跃,杜念宇,臧文斌.商业健康保险对家庭消费的影响[J].中国经济问题,2016(03):68-79.
[12] 高健,李华,徐英奇.商业医疗保险能缓解城乡居民医保家庭“因病致贫”吗?——大病冲击下的经验证据[J].江西财经大学学报,2019(05):81-91.
[13] 张梦林,李国平.商业保险降低家庭贫困脆弱性的政策效应评估与作用机制分析[J].当代经济研究,2020(11):91-102.
[14] 谢明明,刘吉祥,杨孝春.因病支出型贫困与商业医疗保险作用研究[J].中国卫生经济,2021,40(12):37-40.
[15] 郭芮绮,胡依,闵淑慧,等.基于倾向得分匹配的商业医疗保险对我国城乡居民灾难性医疗支出影响研究[J].中国卫生事业管理,2022,39(09):662-665+711.
[16] 汪三贵,孙俊娜.全面建成小康社会后中国的相对贫困标准、测量与瞄准——基于2018年中国住户调查数据的分析[J].中国农村经济,2021(03):2-23.
[17] 张刘晋,马文雯,张加良,等.商业健康保险与基本医疗保险融合发展的国际经验及启示[J].卫生经济研究,2023,40(03):61-64.
[18] 卢佳,邵海亚,彭翔.完善全民健康支持体系:商业健康保险税收优惠政策分析[J].医学与社会,2021,34(12):39-44.
[19] 边恕,李东阳.参加商业医疗保险对中老年家庭消费的影响——基于CHARLS数据的实证分析[J].江西财经大学学报,2021(01):68-79.