城乡基本公共服务均等化与农村流动人口消费——来自医保整合的证据  

Equalization of Basic Public Services and Consumption of Rural Migrants:Evidence from Urban-rural Medical Insurance Integration

作　　者：李隆林 张强[1] 周芯竹 LI Longlin;ZHANG Qiang;ZHOU Xinzhu(School of Management,Shanghai University of Engineering Science,Shanghai 201620,China)

机构地区：[1]上海工程技术大学管理学院,上海201620

出　　处：《华北水利水电大学学报（社会科学版）》2024年第6期88-100,共13页Journal of North China University of Water Resources and Electric Power(Social Science Edition)

基　　金：国家社会科学基金青年项目(19CSH044)。

摘　　要：释放流动人口消费潜力有助于增强消费对经济发展的基础性作用。基于医疗保险理论和预防性储蓄理论,利用全国流动人口动态监测调查数据(CMDS 2018),通过倾向得分匹配构造反事实框架,研究城乡医保整合对农村流动人口消费的影响,采用逐步回归法和Bootstrap法探究其作用机制。研究发现:城乡医保整合显著提高农村流动人口消费,经过替换变量和数据年份后,结论仍稳健;机制分析表明,灾难性医疗支出减少、预防性储蓄动机降低是城乡医保整合促进农村流动人口消费的主要渠道;异质性分析发现,城乡医保整合后以地级市统筹为主的情况使医保整合对农村流动人口消费的促进效应受到制约,表现为在不同流动距离下,对市内跨县、省内跨市、跨省农村流动人口消费的促进效应依次降低,此外,在不同健康状况下,城乡医保整合对不健康农村流动人口消费的促进效应更强。基于此,从稳步推进城乡基本公共服务均等化,加快基本医保信息互联互通,加快推进基本医保省级统筹和全国统筹方面提出建议。Releasing the consumption potential of the migrants will help strengthen the fundamental role of consumption in economic development.Based on the theory of medical insurance and preventive savings,this paper uses the data of the National floating population Dynamic Monitoring Survey(CMDS 2018),constructs a counterfactual framework through propensity score matching to study the impact of the integration of urban and rural medical insurance on the consumption of rural floating population,and uses stepby-step regression method and Bootstrap method to explore the mechanism.It is found that the urban-rural medical insurance integration can significantly promote the consumption of rural migrants,and the conclusion is still robust after replacing variables and data years.Mechanism analysis shows that the reduction of catastrophic medical expenditure and the reduction of precautionary savings motivation are the main channels for the integration of urban and rural medical insurance to promote the consumption of rural floating population.Heterogeneity analysis showed that the promotion effect of urban-rural medical insurance integration on the consumption of rural migrants had health heterogeneity and travel distance heterogeneity,and the promotion effect on unhealthy migrants was stronger,while the promotion effect on intra-city,intra-provincial and inter-provincial migrants was successively reduced.In addition,under different health conditions,the integration of urban and rural medical insurance has a stronger promoting effect on the consumption of unhealthy rural floating population.Based on this,the paper from promoting equalization of public services and accelerating the provincial pooling of basic medical insurance made two specific recommendations perfect.

关 键 词：基本公共服务均等化 城乡医保整合 农村流动人口 消费 

分 类 号：R197.1[医药卫生—卫生事业管理] F323.89[医药卫生—公共卫生与预防医学]