农村贫困家庭健康风险管理中非正式分担机制分析

Analysis on Informal Risk Sharing Arrangement in Health Related Risk Management for Poor Rural Families

健康风险是农村贫困家庭面临的重要经济风险之一。当负性健康事件发生时,受自身资源和能力的限制,农村贫困家庭应对的主要方式往往依赖于非正式风险分担机制。笔者分析了健康风险非正式分担机制的界定、形式、特征和功能,并借助文献进一步探讨了其与正式风险分担机制之间的相互作用关系。笔者最后提出,健康风险的非正式分担机制有可能成为新型农村合作医疗和特困救助项目的有力补充,但需要纳入到更加灵活、开放、低成本的风险管理框架中,其机制有待于进一步研究。

Health related risk is one of the major economic risks encountered by rural poor families. When shocked by adverse health events, poor families＇ coping strategy largely depends on informal risk sharing arrangements （IRSA） circumscribed by their ability and resources. In this article, the IRSA＇ s definition, forms, features and functions are discussed. Furthermore, the interaction relatiorlship between the IRSA and formal risk sharing arrangements is also discussed by the literature analysis. The IRSA for health related risk management potentially will be compensatory for the on - going new rural cooperative medical system and medical assistance scheme. However, the IRSA needs to integrated into a more flexible, opening, lower cost risk management framework. The mechanism of such a framework need further study.