基本医疗保险与商业健康保险减贫效应比较研究
首发时间:2019-06-28
摘要:十九大以来,脱贫攻坚作为全面建成小康社会决胜阶段的重要战略备受各界关注,而医疗保险在解决因病致贫、因病返贫问题上的重要作用也愈受重视。本文通过构建纳入医疗保险的人力资本索罗模型,结合凯恩斯消费理论,对医疗保险的减贫机理进行了分析,并利用2008-2017年全国31个地区的面板数据,对比研究了基本医疗保险和商业健康保险在全国及区域层面的减贫效应。研究发现:一方面,基本医疗保险和商业健康保险均能显著减贫,但基本医疗保险减贫效果弱于商业健康保险,且存在收入门限特征,不利于低收入群体减贫;另一方面,基本医疗保险和商业保险减贫均存在显著的区域差异,且两者表现出较强的互补性;同时,经济基础、人力资本及人口结构均能影响减贫,且因区域资源异质性而呈现出减贫效果的区域差异。鉴于此,加快基本医疗保障体系的全面统筹,提高对低收入群体及欠发达地区的医疗保障支持,引导商业健康保险在重点扶贫区的大力发展,并结合区域资源差异统筹优化整体扶贫政策,或为推动现阶段脱贫攻坚并优化医疗保障制度的可行之径。
关键词: 金融学 基本医疗保险 商业健康保险 减贫效应 门限效应 区域差异
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A Comparative Study on the Poverty Reduction Effect of Basic Medical Insurance and Commercial Health Insurance
Abstract:Since the 19th national congress of the communist party of China, as an important strategy in the decisive stage of building a moderately prosperous society in all respects, poverty alleviation has received much attention. And the important role of medical insurance in solving the problem of poverty and returning to poverty caused by illness is also getting more and more attention. By incorporating health insurance into the Solow model of human capital and combining with the Keynesian consumption theory, this paper analyzes the poverty reduction mechanism of health insurance, and then makes a comparative study on the poverty reduction effects of basic medical insurance and commercial health insurance at the national and regional levels by using 2008-2017 panel data of 31 regions across the country. The findings are as follows: on the one hand, both basic medical insurance and commercial health insurance can significantly reduce poverty, but the poverty reduction effect of basic medical insurance is weaker than that of commercial health insurance, and it has the characteristics of income threshold, which is not conducive to poverty reduction of low-income groups. On the other hand, basic medical insurance and commercial insurance have significant regional differences in poverty reduction, and the two show strong complementarity; At the same time, economic foundation, human capital and demographic structure can all affect poverty reduction, and the regional difference in poverty reduction effect is shown due to resource heterogeneity. In view of this, accelerating the overall planning of the basic medical security system, improving the medical security support for low-income groups and less developed areas, guiding the commercial health insurance to develop vigorously in the key poverty-stricken areas, and improving the overall poverty alleviation policy combining with regional resources differences, can be the feasible optimization path for the current stage of deep poverty alleviation and the optimization of the medical security system.
Keywords: Finance Basic medical insurance Commercial health insurance Poverty reduction Threshold effect Regional differences
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基本医疗保险与商业健康保险减贫效应比较研究
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