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    A Study of the Impact of Non-Agricultural Employment and Basic Medical Insurance on Rural Labor Force Consumption
    TAO Chun-hai, XIONG Qi-zhe, XU Yu-ming
    Journal of Jiangxi University of Finance and Economics    2024, 0 (4): 59-72.  
    Abstract25)            Save
    Based on the micro-survey data of CHFS 2019, this paper makes an analysis of the impact of non-farm employment on the consumption of rural labor force and the moderating effect of the basic health insurance. The findings show that non-agricultural employment can promote rural labor force consumption, and that the length of non-farm employment and the proportion of non-farm income can both significantly improve the level of rural labor force consumption. To choose the urban employee basic medical insurance and the urban and rural labor force basic medical insurance will both have a positive moderating effect on the relationship between non-agricultural employment and rural labor force consumption, while choosing the new rural cooperative medical insurance will have a negative moderating effect. As for different regions and different age groups, to choose the different types of basic medical insurance will have different effects on the relationship between non-agricultural employment and rural labor force consumption. The choice of the basic medical insurance for urban employees by rural labor force will positively promote the impact of non-agricultural employment on the upgrading of consumption structure. Therefore, it is proposed to strengthen the guarantee of non-agricultural employment for rural labor force, increase the participation rate of rural labor force in non-agricultural employment, and promote the coordinated development of the basic medical insurance systems among the regions. It is necessary to explore the consumption potential of rural labor force, and promote the upgrading of rural consumption, so as to better promote the implementation of the rural revitalization strategy and provide reference to the construction of a new development pattern of“dual circulation”.
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    The Paid Contract Services of Family Doctors and the Public Healthcare Behavior: From the Perspective of Medical-Prevention Integration
    LI Zi-hao
    Journal of Jiangxi University of Finance and Economics    2024, 0 (4): 73-86.  
    Abstract20)            Save
    The family doctor signing system is an important foundation for the supply of integrated medical and preventive services. This study uses the data from the China Health and Elderly Care Tracking Survey 2018 to investigate the mechanism of paid family doctor signing services on public medical behavior and choice. The findings of this paper show that from the perspective of medical service utilization, paid family doctor contract services can effectively promote their medical service utilization behaviors, and the improvement effect on outpatient behavior is stronger than that on hospitalization. From the perspective of medical expenses, participating in paid contracts can significantly reduce residents’ self payment expenses for medical. From the perspective of grassroots first visit behavior, paid family doctor contract services can effectively regulate resident hospitalization behaviors in grassroots first visits, but have no significant improvement effect on outpatient services. From the perspective of the impact mechanism, medical service satisfaction plays a mediating role in the mechanism of paid contract signing on hospitalization behavior, but does not affect outpatient behavior. From the perspective of accessibility to medical resources, both outpatient and inpatient medical distances can positively moderate the impact of paid contracts on medical out-of-pocket expenses, while only a negative moderating effect of inpatient medical distance is found in the impact on grassroots first visit behavior. Based on the above findings, this article suggests relying on paid contract services to improve the utilization level of medical services, strengthen the capacity of grassroots medical and health services, include paid contracts in medical insurance to further reduce patient self payment costs, and improve the accessibility and public satisfaction of grassroots medical and health services.
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    A Study on the Impact of Pension Insurance Benefits on the Service Pricing of Private Elderly Care Institutions
    LI Quan-lun, XIA Xue-qing
    Journal of Jiangxi University of Finance and Economics    2024, 0 (3): 49-63.  
    Abstract41)            Save
    By making use of the data from “An-yang-bang”platform in 2022 and China Health and Retirement Longitudinal Study in 2018, this paper estimates the impact of the improvement of the basic pension benefits of urban workers on the prices of elderly care services of private institutions. The findings show that an average increase of 1% in the basic pension benefits of urban workers would result in an increase of 0.48% and 0.36% in the minimum and maximum prices of the elderly care services of the private institutions, respectively. The increase of the pension benefits would increase the demand for institutional care services for the elderly in urban areas, which in turn increases the price of private institutional care services. In addition, the increase of the pension benefits will have a greater impact on the prices of private institutions that are larger, located in central urban areas, and operating for a shorter time. The reform of the elderly care service system can be promoted by establishing pricing guidelines for private elderly care institutions, integrating pension insurance benefits with elderly care service policies, and optimizing subsidy mechanisms for private elderly care institutions, so as to facilitate the sustainable development of these institutions.
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    Long-Term Care Insurance Policy: Essential Characteristics, Implementation Effect and Overflow Effect Based on the Investigation of the Pilot City of Z District in Nantong
    SU Hui, WANG Lin, LIU Hua
    Journal of Jiangxi University of Finance and Economics    2024, 0 (3): 64-77.  
    Abstract58)            Save
    Based on the survey and interview data of Z District in Nantong, which is among the first batch of pilot cities in China, this paper investigates the implementation effect of the long-term care insurance policy. The findings show that the long-term care insurance policy can provide economic support for the disabled elders and their families through the way of social aid; at the same time by perfecting the care service system, this policy can help the families of the disabled elders to turn their economic supports into care services to a certain extent, thereby achieving its basic policy objectives. For now, however, the utilization rate of the long-term care insurance policy is still low, and the release of the family labor force is limited, especially in rural areas. At the same time, the long-term care insurance policy has the spillover effect of promoting the development of the pension industry and promoting the optimal allocation of medical insurance resources to a certain extent. In the future policy implementation, the richness and practicability of the home service content should be increased, while the duration and frequency of service should be increased. The government should gradually reduce the intervention in the elderly service market, and introduce a benign market competition mechanism, so as to promote the improvement of the pension service level.
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    A Study on the Impact of Social Pension Insurance on the Physical and Mental Health of the Elderly
    JIANG Sheng-zhong, GUO Xiu-qi, YAN Shu-han, WANG Jia-lu
    Journal of Jiangxi University of Finance and Economics    2024, 0 (2): 41-55.  
    Abstract87)            Save
    Based on the data from the 2018 China Health and Retirement Longitudinal Study, this paper uses the multiple linear regression model to empirically analyze the relationship between whether or not to enroll in social pension insurance and the amount of pension and the physical and mental health of the elderly. It also incorporate life satisfaction, preventive medical service utilization and social activities as mechanism variables into the analytical frameworkto specifically analyze the internal mechanisms through which social pension insurance affects the health of the elderly. The findings show that whether or not to participate in social pension insurance has little effect on the health status of the elderly, while the level of pension has a significant positive relationship with the health level of the elderly. The pension level can enhance the health of the elderly through the improvement of life satisfaction, the preventive medical service utilization and the social activities. Further research reveals that the pension level has a more pronounced effect on the mental health of the urban elderly. In view of this, it is recommended to improve the social pension insurance system, steadily raise the level of pension benefits, and pay attention to the construction of the supporting system for pension services, so as to strengthen the role of social pension insurance in promoting the health of the elderly.
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    The Influence of Resident Medical Insurance Outpatient Coordination on Doctor-Patient Behaviors
    DING Shao-qun, ZHOU Yu-xuan
    Journal of Jiangxi University of Finance and Economics    2024, 0 (2): 56-68.  
    Abstract53)            Save
    The reform of outpatient coordination of the medical insurance plays a key role in optimizing the order of patients’ medical care and guiding the functional positioning of hospitals. This study adopts thedistrict and county data of the urban and rural residents’ health insurance outpatient coordination from 2008 to 2021 in 21 prefectural cities and states in Sichuan Province and matches them to the local mesoscopic data in the Wind Database to empirically test the impact of the outpatient coordination reform on the residents’ choice of medical treatment and the treatment behaviors of the medical institutions with the progressive double-difference method. The findings show that the outpatient coordination reform has reduced the proportion of hospital consultations and admissions by 1.3% and 1.8% respectively, while the proportion of the consultations and admissions in the primary health care institutions has increased by 1.4% and 1.8% respectively. The reform has led to a 2.4% increase in the rate of inpatient surgery in public hospitals, while the number of bed days and the bed utilization rate have dropped significantly, and the outpatient coordination has led to a further reorganization of the functions of public hospitals. It is recommended that the allocation of primary medical care resources be further strengthened, that public hospitals be monitored for their treatment practices, and that the experience of building close-knit medical communities be promoted as soon as possible.
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    A Study on the Reasonable Growth Mechanism of Urban and Rural Residents’ Basic Pension: Taking Jiangsu Province as an Example
    CAO Si-yuan, LIN Min-gang
    Journal of Jiangxi University of Finance and Economics    2024, 0 (1): 54-68.  
    Abstract77)            Save
    In the context of the high-quality social security development, the basic pension scheme for urban and rural residents is faced with such major problems as lower security levels,undecided benefits determination, inadequate regular adjustment mechanisms, etc.. Taking Jiangsu Province as an example, this paper measures the lower and the upper limits of the reasonable insurance level for theurban-rural pension system. The calculation shows that the lower limit of the reasonable insurance level for 2016-2020 is between 611.71 yuan/month and 771.00 yuan/month, and the upper limit is between 880.34 yuan/month and 1239.37 yuan/month. Therefore, the lower and upper limits of the reasonable replacement rate are determined at 40.73% and 60.97%, respectively. After comparing with the actual value, it is found that the lower limit of the reasonable insurance level far exceeds the lower limit of the actual insurance level. After the strong intervention of the compensation standard raising measures, it is estimated that the higher value of the insurance level may exceed the upper limit of the reasonable insurance level. To this end, specific improvement plans are proposed from the two main aspects: improving the payment level to a reasonable range and establishing a basic pension index adjustment mechanism. It is suggested, based on different payment years, to set a lower limit of 2704~4656 yuan/year and an upper limit of 4441~7504 yuan/year for the higher reasonable payment range and a lower limit of 542~2142 yuan/year and an upper limit of 2279~7504 yuan/year for the lower reasonable payment range. It is recommended to jointly determine the adjustment range of basic pension index benefits with 60% of the annual CPI and 100% of the per capita disposable income growth rate of rural residents.
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    The Influence of Horizontal Differences of Local Financial Resources on the Equalization of Social Security Expenditure
    REN Bin, LIN Yi
    Journal of Jiangxi University of Finance and Economics    2024, 0 (1): 69-82.  
    Abstract36)            Save
    Optimizing social security expenditures by governments at all levels is an important task in promoting the equalization of basic public services, and the reasonable allocation of expenditure responsibilities must be based on the government financial resources. Based on the data of 25 provinces and 243 prefecture-level cities, this paper adopts the relational data analysis paradigm to conduct an empirical study of the impact of the horizontal differences in local financial resources on the equalization of social security expenditures. The findings show that, firstly, the horizontal difference of financial resources has an inhibitory effect on the equalization of social security expenditure at both provincial and prefecture-level cities, and it is stronger at the prefecture-level city level. Secondly, at the provincial level, this effect is manifested at the provincial level as an increasing trend in the central, western, and eastern regions; on the contrary, at the level of prefecture level cities, it shows an increasing trend in the eastern, western, and central regions. Thirdly, whether at the provincial level or prefecture level, the structure of government fiscal expenditure and the central government supervision of social security are important intermediary factors that affect the equalization of social security expenditures due to horizontal differences in financial resources. Based on this, to promote the equalization of social security expenditure in China, the state needs to strengthen the horizontal adjustment of local financial resources and optimize the "hierarchical" design of the equalization top-level system, as well as improve the central transfer payment mechanism.
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    The Impact of Long-Term Care Insurance on the Financial Burden of Medical Insurance for Urban and Rural Residents: From the Regional Perspective and Based on Substitution Effect
    TANG Wei, YU Xing-ran, SU Fang
    Journal of Jiangxi University of Finance and Economics    2023, 0 (6): 40-55.  
    Abstract83)            Save
    With the deepening of population aging and the increase in medical expenses, the ability of urban and rural residents to pay for medical insurance has weakened, and the financial pressure has been increasing year by year. In order to reduce the personal payment burden, some pilot areas of long-term care insurance adopted a financing method of relying on medical insurance fund transfer during the initial implementation of the system. If this financing method continues, what impact will it have on the financial burden of the medical insurance fund in the future? Based on an actuarial model of medical insurance that includes substitution effects, this paper simulates the operation of long-term care insurance funds and the medical insurance funds in various regions from 2021 to 2050. The results indicate that when the two systems operate independently, the financial burden of medical insurance will significantly increase. If the long-term care insurance relies entirely on medical insurance funds, both the current and cumulative deficits will be advanced by 6 years. If the long-term care insurance has a substitution effect on medical expenses, when the substitution factor for home care subsidies is 2.043, promoting the long-term care insurance nationwide will not have any impact on the sustainability of the medical insurance fund. Therefore, adopting a financing method that relies on the transfer of medical insurance funds during the initial operation of the system will not bring excessive financial burden, but it will help to expand the coverage rate and provide guarantee for the gradual independent operation of the long-term care insurance system.
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    Reform of the Financing and Security Mechanism for Urban and Rural Old-Age Insurance and Optimization of the Fiscal Subsidies Structure
    XU Ding, YANG Zai-gui
    Journal of Jiangxi University of Finance and Economics    2023, 0 (6): 56-67.  
    Abstract74)            Save
    According to the 14th Five-Year Plan for the development of human resources and social security undertakings, the financing mechanism of endowment insurance for urban and rural residents should be optimized, the interest calculation method of individual accounts should be standardized, and the mechanism for determining the benefits and the regular adjustment of basic pension should be fully implemented. By constructing an actuarial model, this paper examines how the comprehensive reform of the financing and safeguard mechanism of endowment insurance for urban and rural residents affects the alignment between the financial subsidy structure and the subsidy policy orientation. The findings show that coordinating and adjusting the government’s subsidy model for contributions, increasing collective subsidies, reforming individual account interest calculation methods, and increasing the number of years of basic pension can significantly improve the compatibility of subsidy structure and policy incentive orientation, and that coordinating the increase in the growth rate of basic pension and the elderly basic pension will enhance the compatibility between the subsidy structure and the policy’s inclusive orientation. The sensitivity test results are stable, and the minimum standard growth rate of basic pension, the minimum contribution grade and the accounting interest rate of individual accounts have a strong influence on the fiscal subsidy, while the other factors have a weaker influence.
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