医疗保险与精准扶贫——基于贫困脆弱性视角

摘要/Abstract

摘要： 基于2014—2018年中国家庭追踪调查（CFPS）数据,探讨医疗保险中家庭成员参保率对贫困脆弱性的影响,并进一步分析家庭成员参保率对不同收入水平家庭贫困脆弱性的影响。研究发现,提高家庭成员参保率能显著降低家庭贫困脆弱性,但这种作用在不同收入水平家庭中具有明显的差异,在低收入水平家庭最显著,其次是中高收入水平家庭。在受到大病风险冲击时,提高家庭成员参保率能显著降低家庭贫困脆弱性,但对中高收入水平家庭的效果略强于低收入水平家庭。对于基于不同绝对贫困线和相对贫困线标准计算的贫困脆弱性,该结论依然稳健。此外,改善家庭成员健康状况是医疗保险降低贫困脆弱性的重要中介渠道。

关键词: 医疗保险, 贫困脆弱性, 精准扶贫

Abstract: Based on the data of China Family Panel Studies (CFPS) from 2014 to 2018, this paper explores the impact of the rate of family members joining the medical insurance on the vulnerability to poverty. Then it further analyzes the impact of the rate of family members joining the insurance on the poverty vulnerability of the families with different income levels. The results show that improving the rate of coverage can effectively reduce household vulnerability to poverty. However, this kind of effect has obvious differences among the households with different incomes; it is most significant among the low-income households, followed by middle and high-income households. When being suffered from catastrophic medical risks, improving the rate of coverage of the family members can significantly reduce the household vulnerability to poverty, but this effect on the households with middle and high-income is a little bit stronger than that on the households with low-income. As for the vulnerability to poverty calculated on the basis of different absolute poverty standards and relative poverty standards, this conclusion is still robust. Moreover, to improve the health conditions of family members is an important intermediary channel to reduce the vulnerability to poverty with the medical insurance.

Key words: medical insurance, vulnerability to poverty, targeted poverty alleviation

中图分类号:

F840.613

陈莹, 赵桂芹. 医疗保险与精准扶贫——基于贫困脆弱性视角[J]. 江西财经大学学报, 2022, 0(2): 59-73.

CHEN Ying, ZHAO Gui-qin. Medical Insurance and Targeted Poverty Alleviation: From the Perspective of Poverty Vulnerability[J]. Journal of Jiangxi University of Finance and Economics, 2022, 0(2): 59-73.

参考文献

[1] 方黎明, 张秀兰. 中国农村扶贫的政策效应分析——基于能力贫困理论的考察[J]. 财经研究, 2007,(12):47-57.
[2] 姚洪心, 王喜意. 劳动力流动、教育水平、扶贫政策与农村收入差距——一个基于multinomial logit模型的微观实证研究[J]. 管理世界, 2009,(9):80-90.
[3] 卢盛峰, 卢洪友. 政府救助能够帮助低收入群体走出贫困吗?——基于1989—2009年CHNS数据的实证研究[J]. 财经研究, 2013,(1):4-16.
[4] 黄薇. 医保政策精准扶贫效果研究——基于URBMI试点评估入户调查数据[J]. 经济研究, 2017,(9):117-132.
[5] 刘子宁,郑伟,贾若,景鹏. 医疗保险、健康异质性与精准脱贫——基于贫困脆弱性的分析[J]. 金融研究, 2019,(5):56-75.
[6] Vo T.T., Van P. H. Can Health Insurance Reduce Household Vulnerability? Evidence from Viet Nam[J]. World Development, 2019, 124(December): 1-16.
[7] 解垩. 医疗保险与城乡反贫困:1989—2006[J]. 财经研究, 2008,(12):68-83.
[8] Hamid S.A., Roberts J., Mosley P. Can Micro Health Insurance Reduce Poverty? Evidence from Bangladesh[J]. Journal of Risk and Insurance, 2011, 78(1): 57-82.
[9] 万广华,刘飞,章元. 资产视角下的贫困脆弱性分解:基于中国农户面板数据的经验分析[J]. 中国农村经济, 2014,(4):4-19.
[10] 樊丽明,解垩. 公共转移支付减少了贫困脆弱性吗?[J]. 经济研究, 2014,(8):67-78.
[11] Liu G.G., Zhao Z. Urban Employee Health Insurance Reform and the Impact on Out-of-pocket Payment in China[J]. The International Journal of Health Planning and Management, 2006, 21(3): 211-228.
[12] Uplekar M., Pathania V., Raviglione M.Private Practitioners and Public Health: Weak Links in Tuberculosis Control[J]. The Lancet, 2001, 358(9285): 912-916.
[13] Gertler P., Gruber J.Insuring Consumption Against Illness[J]. American Economic Review, 2002, 92(1): 51-70.
[14] Akotey J.O., Adjasi C. The Impact of Microinsurance on Household Asset Accumulation in Ghana: An Asset Index Approach[J]. Geneva Papers on Risk and Insurance-Issues and Practice, 2014, 39(2): 304-321.
[15] 齐良书. 新型农村合作医疗的减贫、增收和再分配效果研究[J]. 数量经济技术经济研究, 2011,(8):35-52.
[16] Damme W.V., Leemput L.V., Por I., Hardeman W., Meessen B. Out-of-pocket Health Expenditure and Debt in Poor Households: Evidence from Cambodia[J]. Tropical Medicine & International Health, 2004, 9(2): 273-280.
[17] Liu K.Insuring Against Health Shocks: Health Insurance and Household Choices[J]. Journal of Health Economics, 2016, 46(March): 16-32.
[18] 于新亮, 上官熠文, 申宇鹏, 于文广. 因病致贫:健康冲击如何影响收入水平?——兼论医疗保险的脱贫效应[J]. 经济社会体制比较, 2020,(4):30-40.
[19] 潘杰, 雷晓燕, 刘国恩. 医疗保险促进健康吗?——基于中国城镇居民基本医疗保险的实证分析[J]. 经济研究, 2013,(4):130-142.
[20] 周钦, 田森, 潘杰. 均等下的不公——城镇居民基本医疗保险受益公平性的理论与实证研究[J]. 经济研究, 2016,(6):172-185.
[21] 潘杰, 秦雪征. 医疗保险促进健康吗?——相关因果研究评述[J]. 世界经济文汇, 2014, (6): 60-70.
[22] 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, (2): 41-53.
[23] 何兴强, 史卫. 健康风险与城镇居民家庭消费[J]. 经济研究, 2014, (5): 34-48.
[24] 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.
[25] Wagstaff A., Lindelow M., Jun G., Ling X., Juncheng Q.Extending Health Insurance to the Rural Population: An Impact Evaluation of China’s New Cooperative Medical Scheme[J]. Journal of Health Economics, 2009, 28(1): 1-19.
[26] Lei X., Lin W.The New Cooperative Medical Scheme in Rural China: Does More Coverage Mean More Service and Better Health?[J]. Health Economics, 2009, 18(s2): s25-s46.
[27] 程令国, 张晔. “新农合”:经济绩效还是健康绩效?[J]. 经济研究, 2012, (1): 120-133.
[28] 臧文斌, 刘国恩, 徐菲, 熊先军. 中国城镇居民基本医疗保险对家庭消费的影响[J]. 经济研究, 2012, (7): 75-85.
[29] Zhao W.Does Health Insurance Promote People’s Consumption? New Evidence from China[J]. China Economic Review, 2019, 53(February): 65-86.
[30] Chaudhuri S., Jalan J., Suryahadi A.Accessing Household Vulnerability to Poverty from Cross-sectional Data: A Methodology and Estimates from Indonesia[R]. Working Paper, 2002.
[31] Ameniya T.The Maximum Likelihood Estimator and the Nonlinear Three-Stage Least Squares Estimator in the General Nonlinear Simultaneous Equation Model[J]. Econometrica, 1977, 45(4): 955-968.
[32] Gottlieb D., Fruman A.A Quality-Index of Poverty Measures[R]. ECINEQ Working Paper, 2011.
[33] 高梦滔,姚洋. 健康风险冲击对农户收入的影响[J]. 经济研究,2005,(12):15-25.
[34] 温忠麟,侯杰泰,张雷. 调节效应与中介效应的比较和应用[J]. 心理学报, 2005, (2): 268-274.