城乡医保整合政策是否缓解了农村中老年家庭消费不平等?  

Has the Gradual Integration of Medical Insurance Alleviated the Consumption Inequality among Elderly Rural Households?

作　　者：初可佳 唐世瑀 谢观霞 CHU Ke-jia;TANG Shi-yu;XIE Guan-xia(School of International Education,Guangdong University of Finance,Guangzhou 510630,China;Graduate Student Department,Guangdong University of Finance,Guangzhou 510630,China)

机构地区：[1]广东金融学院国际教育学院,广东广州510630 [2]广东金融学院研究生处,广东广州510630

出　　处：《经济问题》2025年第3期29-41,共13页On Economic Problems

基　　金：国家自然科学基金面上项目“粤港澳大湾区社会保障制度衔接机制与协同治理研究”(72173033);国家自然科学基金青年项目“异质性偏好视阈中ESG信息披露对企业高质量发展的影响研究”(72403058)。

摘　　要：缩小消费差距对实现共同富裕以及推动经济长期稳定发展具有重要意义。以往研究主要关注城乡之间的消费差距,较少关注农村中老年家庭面临的消费不平等问题。鉴于此,基于2011—2020年中国健康与养老追踪调查(CHARLS)数据,通过户均消费支出测算的Kakwani指数构建消费不平等测度指标,使用渐进DID模型实证分析城乡居民基本医疗保险的渐进式整合政策对农村中老年家庭消费不平等的影响。研究发现,城乡医保整合政策显著缓解了该群体面临的消费不平等,且该结论在经过剔除干扰政策、Bacon分解和PSM-DID等稳健性检验后依然成立。机制检验发现,城乡医保整合政策主要通过财富效应、代际效应以及健康效应三个渠道产生影响。进一步的异质性研究表明,更为统一的筹资政策和更低的家庭流动性约束能促进上述政策对消费不平等的改善效果。因此,应进一步推进医保整合政策,逐步实现全民一体化的医疗保障制度,使其更加公平地惠及所有城乡居民。This study examines the impact of the gradual integration of urban and rural residents’basic medical insurance on consumption inequality among elderly rural households,using data from the 2011—2020 CHARLS(China Health and Retirement Longitudinal Study)database.The consumption inequality is constructed using the Kakwani index based on per-household consumption expenditure.A multi-period DID(Difference-in-Differences)approach is employed to empirically analyze the effects of the integration policy.The results indicate that the integration of urban and rural health insurance significantly alleviated consumption inequality faced by elderly rural households,and this conclusion remains robust after conducting a series of robustness checks,including exclusion of confounding policies,Bacon decomposition,and PSM-DID analysis.Mechanism analysis reveals that the integration policy’s impact operates primarily through wealth effects,intergenerational effects,and health effects.Further heterogeneity analysis suggests that the policy’s effect on reducing consumption inequality is more pronounced for families in regions with the same level of contribution and for those facing fewer liquidity constraints.Therefore,it is essential to continue advancing the integration of health insurance policies and to ultimately achieve a unified national healthcare system that equitably benefits all urban and rural residents,unleashing the potential consumption and contributing to long-term economic development.

关 键 词：城乡居民医保整合 消费不平等 收入不平等 代际照料 

分 类 号：F126.1[经济管理—世界经济]