城乡基本医疗保险制度实施对家庭消费的影响效应及作用机制  

The Effect and Mechanism of the Implementation of Urban and Rural Basic Medical Insurance System on Household Consumption

作　　者：万广华[1] 杨晨 WAN Guang-hua;YANG Chen

机构地区：[1]复旦大学经济学院 [2]复旦大学世界经济研究所

出　　处：《北京社会科学》2024年第8期60-75,共16页Social Sciences of Beijing

基　　金：教育部高校人文社会科学重点研究基地重大项目(23JJD790001)——双循环格局下贸易对中国内需和共同富裕的影响及对策研究。

摘　　要：基于1988—2018年中国家庭收入调查数据,以城乡基本医疗保险制度实施为准自然实验,采用双重差分法考察了城镇基本医疗保险与新型农村合作医疗保险(即新农合)对家庭消费率的影响及其机制。结果显示:相较于未参保家庭,参加城镇医保的家庭消费率显著高出1.01%,但新农合的影响不显著;机制分析发现,城镇医保促进了参保家庭的总消费和分项消费支出,但新农合对消费支出无显著影响,同时,城镇医保和新农合对总收入和大部分分项收入无显著影响,这与基准回归结果一致;异质性分析表明,城镇医保更多地提升了中老年、非富裕、不健康群体,以及西部地区的家庭消费率。对此,应当充分发挥基本医疗保险制度对提振家庭消费率的积极作用,对“大水漫灌”式的财政补助应进行反思;改变基本医保“户保分离”“业保分离”的现状;加强针对特定人群的医保政策;注重提高参保青年和健康群体的获得感。Based on the household income survey data of China from 1988 to 2018,a natural experiment was carried out with the implementation of the basic medical insurance system in urban and rural areas as the criterion,the effect of urban basic medical insurance and new rural cooperative medical insurance(NRCMS)on household consumption rate and its mechanism were investigated by double difference method.The results show that compared with the uninsured families,the consumption rate of the families participating in urban health insurance is significantly higher by 1.01%,but the effect of NRCMS is not significant.The mechanism analysis finds that urban health insurance promotes the total consumption and individual consumption expenditure of insured families,but the new rural cooperative medical system has no significant impact on consumption expenditure,urban health insurance and NRCMS had no significant effect on the total income and most of the partial income,which was consistent with the results of the baseline regression,urban health insurance has boosted household consumption rates for the middle-aged and elderly,the non-wealthy and the unhealthy,as well as in the west.In this regard,we should give full play to the basic medical insurance system to promote the positive role of household consumption rate,reflect on“Flood”-style financial subsidies.And it is necessary to change the current situation of“Household insurance separation”and“Industry insurance separation”in basic medical insurance,to strengthen the medical insurance policy for specific groups,and to pay attention to improve the sense of access of the insured youth and healthy groups.

关 键 词：双循环 家庭消费率 城镇基本医疗保险 新农合 家庭收入 

分 类 号：F124[经济管理—世界经济] F84