城乡医疗保险市场逆向选择行为及其异质性分析

Study on the Adverse Selection of China's Medical Insurance Market and its Heterogeneity

基于露定效应的Probit模型，分析了中国城乡医疗保险市场逆向选择行为，及其在不同收入水平、不同年龄段和不同性别下的异质性。研究发现，医疗保险市场确实存在逆向选择行为，相比社会基本医疗保险，商业健康保险市场逆向选择行为更明显；相比城市居民，农村居民逆向选择程度更高。社会基本医疗保险中，健康风险较大的低收入人群更倾向于参保，而高收入组中有健康风险的人群更倾向于购买商业健康保险；社会基本医疗保险中各年龄段人群均存在逆向选择行为；商业健康保险中逆向选择行为却主要集中在35～50岁的中年人群；另外，女性在医疗保险市场中普遍存在逆向选择行为。

Based on the fixed effects of Probit model, this paper analyzes the adverse selection behaviors of China＇s medical insurance market, and its heterogeneity with different income, age and gender groups. The results demonstrate the existence of adverse selection behavior in China＇s medical insurance market. Specifically, compared to the basic social medical insurance, adverse selection behavior in the commercial health insurance market is more obvious; rural residents have a higher tendency for adverse selection than urban resi- dents. In addition, people with lower income and higher health risks tend to buy Social basic medical insurance, while people with higher income tend to buy commercial health insur- ance;people with social basic medical insurance have adverse selection behaviors in all age groups ;while the adverse selection behaviors in the commercial health insurance are mainly reflected by people aged between 35 and 50;besides, generally adverse selection behaviors exist among women in medical insurance market.