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  

Inequity of Equalization——Theoretical and Empirical Analysis on Beneficial Equity of the Urban Resident Basic Medical Insurance in China

作　　者：周钦[1] 田森[2] 潘杰[3] 

机构地区：[1]对外经济贸易大学公共管理学院 [2]西南财经大学经济与管理研究院 [3]四川大学华西公共卫生学院

出　　处：《经济研究》2016年第6期172-185,共14页Economic Research Journal

基　　金：国家自然科学基金资助项目(71303165和71303175);四川大学中央高校基本科研业务费研究专项项目(skqx201401);美国纽约中华医学基金会(China Medical Board)资助项目(13-167)的支持

摘　　要：坚持公平是国家医药卫生体制改革的基本原则之一。本文评估了覆盖2.5亿城镇人口的城镇居民基本医疗保险参保个人受益的公平性。理论模型显示,对于政府提供的均等化基本医疗保险,高收入参保人群的受益超过低收入人群。我们利用2007—2011年"国务院城镇居民基本医疗保险试点评估调查"数据,通过两部模型(Two Part Model)等方法对城镇居民基本医疗保险参保个人的受益公平性进行分析,结果与理论模型分析结论保持一致。本文的基本判断是:均等化补偿制度下的基本医疗保险将造成低收入参保人受益的劣势,且由于低收入人群健康水平更差,这样的制度设计将加剧健康的不公平。本研究将为进一步完善中国基本医疗保险制度提供决策参考依据。Benefit equity is one of the principles of the National Medical and Health System Reform Plan. This paper evaluates the benefit equalities of Urban Residents＇ Basic Medical Insurance （URBMI） which covers more than 250 million urban populations in China. From the theory model, we find that, for the equalized designed social health insurance which is equally financed and reimbursed among the insured, the lower income groups will obtain less reimbursement than higher income groups. In the empirical part, using data from URBMI survey from year 2007 to 2011, we apply the two-part model, and find the similar results with the theoretical prediction of the unequal benefits among income groups. We get conclusion that equalized designed social health insurance would bring benefit equalities for the lower income groups. And the lower income groups are always with poorer health, so such health insurance will also intensify health inequities. Our study provides new evidence on reforming China＇s health insurance system policies.

关 键 词：均等化医保制度 医疗服务利用 医保受益公平 医疗改革 

分 类 号：F842.684[经济管理—保险]