目的: 研究城乡居民医保制度整合对农户（以农业生产为主要经济来源的家庭或家庭单位）消费差距的影响。方法: 基于2011—2020年中国健康与养老追踪调查（CHARLS）五期数据,通过构建双重差分模型,分析城乡居民医保制度整合对农户消费差距的影响,并探究其作用机制与异质性作用。结果: 城乡居民医保制度整合显著缩小了农户之间的消费差距,其作用机制主要体现在降低农户自付医疗费用和健康风险。通过异质性分析发现,城乡居民医保制度整合对农村中年人群和低收入家庭影响更显著。结论: 城乡居民医保制度整合在缓解农户之间消费差距方面具有显著作用,在促进消费公平、助力共同富裕目标达成以及推动经济实现长期稳健发展方面有着不可忽视的重要意义。
Abstract
Objective: The paper studies the impact of the integration of urban and rural residents' medical insurance system on the consumption gap among rural households (households or household units with agricultural production as the main source of income). Methods: Based on the five-phase data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, by constructing a difference-in-difference model, the paper analyzes the impact of the integration of urban and rural residents' medical insurance system on the consumption gap among rural households and explores its mechanism and heterogeneous effects. Results: The integration of urban and rural residents’ medical insurance has significantly reduced the consumption gap among rural households, and its mechanism is mainly reflected in lowering the out-of-pocket medical expenses and health risks of rural households. Through heterogeneity analysis, it was found that the integration of urban and rural residents’ medical insurance has a more significant impact on the rural middle-aged population and low-income families. Conclusion: The integration of the medical insurance system for urban and rural residents plays a significant role in alleviating the consumption gap among rural households. It is of indispensable importance in promoting fair consumption, facilitating the achievement of the goal of common prosperity, and driving the long-term stable development of the economy.
关键词
城乡居民医保整合 /
农户 /
消费差距 /
相对剥夺指数
Key words
integration of medical insurance for urban and rural residents /
rural households /
consumption gap /
relative deprivation index
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 程雨,谢春,吴敬杰.基本医疗保险对我国老年人住院服务利用的影响[J].现代预防医学,2021,48(5):845-848+915.
[2] 杨晓玮,闫菊娥,钱玉燕,等.基本医疗保险制度背景下城乡居民因病致贫发生影响因素研究[J].中国卫生事业管理,2021,38(4):269-272.
[3] 马双,臧文斌,甘犁.新型农村合作医疗保险对农村居民食物消费的影响分析[J].经济学(季刊),2011,10(1):249-270.
[4] BAI C, B WU. Health insurance and consumption: evidence from China’s new cooperative medical scheme[J]. Journal of comparative economics, 2014, 42(2):450-469.
[5] 白重恩,李宏彬,吴斌珍.医疗保险与消费:来自新型农村合作医疗的证据[J].经济研究,2012,47(2):41-53.
[6] 程令国,张晔.“新农合”:经济绩效还是健康绩效?[J].经济研究,2012,47(1):120-133.
[7] 臧文斌,陈晨,赵绍阳.社会医疗保险、疾病异质性和医疗费用[J].经济研究,2020,55(12):64-79.
[8] 王晓亚,黄德海,卜鹏滨.医疗保险的双重效应与居民医疗支出:作用机理及实证检验[J].当代经济科学,2018,40(5):1-11+124.
[9] 邵全权,郝天琪.健康风险、医疗保险与消费[J].保险研究,2020(12):18-37.
[10] 周新发,石安其琛.医疗保险对减轻参保农村居民家庭就医负担的异质性研究——来自CFPS数据的经验证据[J].财经理论与实践,2021,42(5):50-56.
[11] 谢明明,王美娇,熊先军.道德风险还是医疗需求释放?——医疗保险与医疗费用增长[J].保险研究,2016(1):102-112.
[12] 姚奕,孙祁祥,林山君,等.健康保险道德风险防范研究——以商业健康保险欺诈为例[J].经济研究,2020,55(6):189-206.
[13] 朱铭来,王恩楠.商业健康保险与医药产业协作发展的分析与展望[J].中国医疗保险,2021(8):71-74.
[14] YU S, X MA , P. ZHAN. Effects of the resident basic medical insurance reform on household consumption in China[J].China & world economy, 2024, 32(1): 96-129.
[15] 蒋云赟,郑恺.城乡居民医疗保险统筹、农村就医行为与消费支出[J].北京航空航天大学学报(社会科学版),2022,35(5):126-138.
[16] 陈昌盛,许伟,兰宗敏,等.我国消费倾向的基本特征、发展态势与提升策略[J].管理世界,2021,37(8):46-58.
[17] 甘犁,赵乃宝,孙永智.收入不平等、流动性约束与中国家庭储蓄率[J].经济研究,2018,53(12):34-50.
[18] 廖朴,刘金浩,冯璐.健康公平视角下的城乡居民医疗支出不平等研究——基于生命周期模型[J].当代经济科学,2024,46(2):1-16.
[19] 黄家林,傅虹桥,宋泽.补充医疗保险对居民消费的影响——来自城乡居民大病保险的证据[J].金融研究,2022(10):58-76.
[20] 易行健,张凌霜,徐舒,等.商业健康保险、预防性储蓄动机与居民消费支出——理论与经验证据[J].金融研究,2023(4):130-148.
[21] 袁胜超,庞瑞芝,吕翠翠.“成本病”是否导致了“看病贵”?——来自中国省级层面的经验证据[J].当代经济科学,2020,42(3):106-116.
[22] 李晓飞,臧旭恒.“多轨制”养老金与家庭消费相对剥夺[J].经济评论,2022(4):130-147.
[23] BECK T, R. LEVINE, A LEVKOV. Big bad banks? the winners and losers from bank deregulation in the United States[J]. The journal of finance, 2010, 65(5): 1637-1667.
[24] 范红丽,王英成,亓锐.城乡统筹医保与健康实质公平——跨越农村“健康贫困”陷阱[J].中国农村经济,2021(4):69-84.
[25] 常雪,苏群,谢浩然.城乡医保统筹对居民医疗负担的影响——基于城乡差别的视角[J].贵州财经大学学报,2021(2):80-89.
[26] 丁继红,应美玲,杜在超.我国农村家庭消费行为研究——基于健康风险与医疗保障视角的分析[J].金融研究,2013(10):154-166.
[27] 蔡伟贤,朱峰.“新农合”对农村居民耐用品消费的影响[J].数量经济技术经济研究,2015,32(5):72-87.
基金
福建省社会科学基金重大项目“福建健全多层次社会保障体系研究”（FJ2023Z017）; 福州市哲学社会科学规划重点项目“福州加快城镇基本公共服务均等化研究”（2022FZB07）
