教育水平、医疗保险与健康风险——为什么医改的目标应是健康保障

Education Level,Medical Insurance and Health Risks——The Goal of Medical Reform Should Be the Construction of Health Security System

使用CHNS(2006)的数据,通过建立健康影响因素模型,分析了个人的身体、经济、社会、行为特征以及医疗卫生资源配置等对健康风险与健康结果的影响。为了解决模型的内生性问题,选用同代人平均受教育程度、社区参加保险比例作为个人教育程度和是否参加医疗保险的工具变量,并在同代人教育水平的计算中考虑了时代的政治事件冲击,以使工具变量有效,不再有弱工具变量问题。两阶段估计结果表明,教育和医疗保险对个人的健康结果存在正向影响,个人的经济、社会特征及健康行为等都会影响健康结果,而医疗卫生资源的地理可及性和价格也会显著影响健康结果。因此,当前医改的目标应当是健康保障,而不仅仅是基本医疗服务的获得。

Using the data of CHNS（2006）,and this paper analyzes the impact on health outcome of physical,economic,social,health behavior and the medical resource distribution,and as the most important technology method,it selects the generation average education level and community medical insurance rate as the instrument variable,and considering the political issue strike to the generation average education level.The tests show that the IV is effective and there is no weak IV problem.The two stage estimation results show that the education level and medical insurance have positive impact on the health outcome,meanwhile,the there is also a comprehensive impact of all the control variables on the dependent variable.According to the final research result,this paper brings forward the final goal of the medical reform is to establish a health security not merely the equitable medical care distribution.