宗亲互助与商业健康保险需求

Clan Mutual Assistance and Commercial Health Insurance Demand

面对"看病难、看病贵",居民可搭配宗亲互助与商业健康保险共同抵御疾病风险。文章利用中国家庭金融调查(CHFS)数据,从文化和转移支出两个角度研究了宗亲互助对商业健康保险需求的影响。结果表明,宗亲互助能够促进居民的商业健康保险需求,考虑内生性影响后结果依然稳健。半参数双重差分结果显示,宗亲互助能够传递疾病风险感知,促进居民的商业健康保险需求。调节效应表明,在参与宗亲互助的低收入人群中,金融素养高的居民,商业健康保险需求更多。异质性分析表明,城市的保障程度高,宗亲互助对商业健康保险需求的促进作用更加显著;在大多数年龄段,宗亲互助都能显著正向影响居民的商业健康保险需求。文章研究表明,日常生活中宗亲互助与商业健康保险并不是非此即彼,两者搭配成为风险转嫁组合更有利于防止因病致贫、因病返贫。

The outbreak of"2019-nCoV"rings the alarm bell of illness risks.Recently,according to"China Statistical Yearbook",the annual growth rate of per capita health care expenditure in China has recorded double-digit since 2014,which is creating huge medical expenditure burdens and hardly ignored in residents’daily life.When pursuing a better life,the difficulties and high costs of getting medical services have threaten residents’normal living for a long time."2019 Medical Trends around the World"issued by Marsh&McLennan Companies indicated that the inflation rate of medical expenditure was up to 9.7%in China2018,which means falling into or falling back to poverty for catching diseases would still bother residents’mind.How to choose an appropriate way of illness risk transfer is an unavoidable problem for residents.Clan mutual assistance has been a traditional way to share the loss of diseases since ancient times,whereas commercial health insurance is a more efficient way in modern market for healthy risk sharing.As a result,clan mutual assistance will influence commercial health insurance demand.However,previous literature only pays attention on the"crowd-out"relationship between clan mutual assistance and commercial health insurance.Those researches ignore that folks can use both clan mutual assistance and commercial health insurance to improve health care levels.Besides,illness risk information can be delivered by clan mutual assistance,which will stimulate clan members’risk perception and improve their commercial health insurance demand.Based on China Household Finance Survey Data(CHFS),this paper sets variables from culture and transfer expenditure perspectives to show that clan mutual assistance can"crowd in"commercial health insurance demand,which is still robust when considering the endogenous effect.In mechanism analysis,by using semiparametric difference-in-difference(SDID),clan mutual assistance impacts commercial health insurance demand by delivering illness risk perception.Besides,the moderating effect indicates that when receiving illness risk information from clan mutual assistance,people who have higher finance literacy in low income group will have more tendencies to buy commercial health insurance.Heterogeneity analyses find that urban group enjoying higher quality social welfare has more"crowd-in"effect than rural group;in the majority of age ranges,clan mutual assistance shows a positive effect on folks’commercial health insurance demand.Therefore,when marketing the commercial health insurance,insurance industry should avoid putting clan mutual assistance and commercial health insurance into two opposite poles,so as to reduce residents’resistance to commercial health insurance.Secondly,insurance industry needs to expand the rural market to give more connections between rural residents and commercial health insurance,which will improve commercial health insurance demand in rural areas.Thirdly,suburb can be a crucial segmental market where insurance industry can explain the limits of clan mutual assistance and persuade new citizens migrating from rural places to use commercial health insurance to share illness risks.