医疗保险制度对收入分配的影响——基于陕西省的分析

Study on Income Redistribution Effect of Medical Insurance System:Based on Shaanxi Province

文章以陕西省城乡居民为研究对象,使用洛伦兹曲线和基尼系数等指标,运用平衡预算归宿方法,从医疗保险缴费和受益两个方面测算了医疗保险制度对收入分配的影响及其变化。研究发现,总体上医疗保险制度不但没有发挥调节收入再分配的作用,反而存在低收入群体补贴高收入群体的"逆向再分配"现象。虽然医疗保险缴费额与收入成正比,但在报销医疗费方面低收入群体的数额更低,医疗保险的综合效应没有改善低收入群体的状况,并且农村医疗保险的公平性更低。因此,为缩小收入差距,实现筹资公平和受益均等,应统筹城乡医疗保险发展,增加对弱势群体的补贴和照顾,满足不同群体的医疗需求。

Focusing on urban and rural residents in Shaanxi province, this paper uses Lorenz curve, Gini coefficient, and balancing budget incidence to measure the influences and changes of medical insurance system on income redistribution in medical insurance payment and reimbursement. The results show that overall medical insurance system does not have a positive income redistribution effect, but has a 'reverse redistribution' effect from low-income groups to high-income groups. Specifically, although medical insurance payment is proportional to income, low-income groups have less reimbursement. Therefore, medical insurance does not benefit low-income groups, and the fairness of rural medical insurance is poor. To narrow the income gap and realize financing fair and equal benefit, we should unify urban and rural medical insurance, increase subsidies for disadvantaged groups and meet the diverse demands between different groups.