我国医疗保险制度改革的家庭收入分配效应研究——基于CHNS 2000—2011的分析

On the Household Distribution Effects of Medical Insurance Reform in China CHNS 2000-2011

利用CHNS 2000到2011年5期混合截面数据,考察了我国医疗保险制度改革对家庭间收入分配的动态影响。2SLS回归分析显示,家庭成员医保参保行为对其家庭总收入产生了显著的正向影响,其中公费医疗、城镇职工医保、城镇居民医保的显著性影响依次降低。随着改革的逐年推进,是否参保对家庭总收入的影响存在从统计显著性到绝对数值上的"U"型变化;基于G·Field分解的进一步研究发现,总体上系列医保制度改革对缓解我国收入不平等发挥了积极作用,但近年来对家庭收入差距的贡献率却反负为正,这一现象值得高度关注。政策层面,应全面实施强制参保,谨防医保收入补偿效应拉大收入差距。同时力争快速、高效地推进医保制度改革,将改革进程的负效应降到最低。

Based on the pooled cross-sectional data of CHNS 2000-2011,this paper gives a test on the household distribution effect of medical insurance reform in China. 2 SLS regression analysis indicates that,those families in which family members bought medical insurance tend to have higher household income thoroughly. As free medical care system,urban employee medical insurance system,and urban resident medical insurance system are in rank,the marginal positive effect decreases gradually. Considering whether the family bought insurance or not,the impact of insurance on total family income has a "U"change from statistical significance to absolute figure. In addition,the study based on the G·Field's decomposition analysis demonstrates that,medical insurance reforms play a positive role in narrowing income gap,however,in recent years,it also make positive contributions to widening income gap. Our government should implement medical insurance compulsorily,beware of the effect of medical insurance income compensation to widen the income gap,and boost reforms efficiently to lower the negative effects to the minimum.