迈向共同富裕的基本医疗服务均等化研究——基于中国城乡居民大病保险视角  

A Research on Equalization of Primary Healthcare Services towards Common Prosperity:From the Perspective of Critical Illness Insurance for Urban and Rural Residents in China

作　　者：邹国昊 张颖[1] 杨楚风 Zou Guohao;Zhang Ying;Yang Chufeng(School of Economics and Management,Southeast University,Nanjing 211189,China;Business School,National University of Singapore,Singapore 119245,Singapore)

机构地区：[1]东南大学经济管理学院,江苏南京211189 [2]新加坡国立大学商学院,新加坡119245

出　　处：《财经研究》2024年第12期33-46,共14页Journal of Finance and Economics

基　　金：国家社会科学基金项目(22BGL029)

摘　　要：城乡居民大病保险作为推进国家基层医疗卫生体系建设、促进基本医疗服务均等化的重要内容,是扎实推进全体人民共同富裕的关键。文章基于中国城乡居民大病保险视角,使用2010—2018年中国家庭追踪调查数据(CFPS),从物质富裕、精神富裕、社会共享等多维度构建共同富裕指数评价体系,运用双重差分法评估基本医疗服务均等化对共同富裕的影响。文章研究发现:(1)大病保险能增进收入分配的普惠性,驱动微观个体可支配收入水平提升,并减少社区、区县、城市及省份等多层次社会网络的可支配收入差距,是促进城乡共同富裕的有效方式。(2)机制分析表明,大病保险能通过缩小医疗负担城乡差距、提高医疗资源配置效率和缓解流动性约束,促进共同富裕水平提升。(3)异质性分析表明,在个体方面,大病保险强化了非认知能力,促进人力资本提升;在家庭方面,其丰厚社会资本发挥“非正式保险”作用;在区域方面,其发展数字普惠金融改善金融服务可及性。这些均有助于提升大病保险助推共同富裕成效。(4)立足于扩大内需的视角,大病保险提升了可支配收入,改善了居民消费,两者具有联动性;基于效率与公平视角,大病保险在推进共同富裕进程中未造成显著的效率损失,展现了“公平和效率”的相容性。As an important component of advancing the construction of the national primary healthcare system and promoting the equalization of basic medical services,the critical illness insurance for urban and rural residents is a key element in solidly promoting common prosperity.From the perspective of China’s critical illness insurance for urban and rural residents and using data from the China Family Panel Studies(CFPS)from 2010 to 2018,a scientifically comprehensive evaluation system of the common prosperity index is constructed from multiple dimensions.The DID method is used to evaluate the impact of the equalization of basic medical services on common prosperity.The findings indicate that:(1)Critical illness insurance can enhance the inclusiveness of income distribution,drive the increase in disposable income at the micro-individual level,and mitigate the disposable income gap across multi-level social networks.Mechanism testing shows that critical illness insurance can promote common prosperity by narrowing the urban-rural gap in medical burdens,improving the efficiency of medical resource allocation,and alleviating liquidity constraints.(2)From the perspective of expanding domestic demand to facilitate domestic circulation,the increase in disposable income brought about by critical illness insurance is linked to improvements in residents’consumption and investment.The study empirically investigates the impact of critical illness insurance on common prosperity,and provides important references for accurately assessing the welfare boundaries of the critical illness insurance policy and further improving regional critical illness insurance policy arrangements.

关 键 词：大病保险 共同富裕 收入差距 收入水平 

分 类 号：F840.684[经济管理—保险] F126