挤入还是挤出:社会保障对子女经济供养老人的影响——关于医疗保障与家庭经济供养行为

Impact of Social Security on Child Economic Support for the Elderly

社会保障对子女经济供养老人的影响一直是学术界关注的热点问题。基于实地调研数据,控制其他变量基础上,重点分析社会保障对子女经济供养老人的影响,研究结果显示,社会保障总体上对子女经济供养老人的水平具有挤入效应,老年人获得社会保障总体上将提高子女对其经济供养水平。而解释机制分析则发现,原因在于医疗保障释放了老年人的医疗卫生服务需求,进而增加了相应支出,并最终导致子女增加了经济供养支出。进一步分析发现了该效应的群体差异性,而该效应实质是医疗卫生资源和服务分配的阶层性差异,根源在于现行医疗卫生制度存在的各种弊病。在研究结论基础上,提出了建立公平的健康保障与福利改进体系等思考。

Social Security＇s effect on child economic support for ageing parents has been a central issue in academic research and debate. Drawing upon data from 2011 Aged Care at Home Survey in China, this paper analyzes the factors that influence child economic support for their parents, including the basic characteristics of the elderly themselves, family condition, and income of their children. Focus is placed on the impact of social security. Results show that social security for the elderly generally leads to a higher level of child economic support, this is because social security releases demands for medical and health services of the elderly, increasing the related expenditure and child economic support. There are differential impacts among sub - groups of the elderly, which are essentially differences between social strata in distribution of medical and health resources and services as a result of the various drawbacks of the current medical and health system. Policy implications for equalizing health security and improving welfare are discussed.