城乡医保统筹对居民健康的影响

The Effects of Urban-rural Integrated Medical Insurance System on Health

文章利用2012和2014年中国劳动力动态调查(CLDS)数据,建立双重差分回归模型,实证检验实行城乡居民医疗保险统筹对15～64岁城乡居民健康的影响及作用机制。回归结果表明,推行城乡医保统筹有利于居民健康,能够减轻健康对工作的负面影响,提高居民的自评健康水平。医保统筹对城乡居民的影响存在差异,对农村居民的影响大于城镇居民。通过对影响路径的分析发现,统筹制度减少了农村居民患病后不就诊的行为,进而降低了农村居民因病影响工作的程度,对城镇居民健康的积极作用则主要体现为可以提高其自评健康水平。虽然城乡医保统筹对改善健康具有积极作用,但并不能降低居民的患病率,因此,应当倡导保健和疾病预防,降低居民患病率,从改善健康的路径看,应当从改变就医行为入手,鼓励居民患病后采取积极的治疗方式。

Based on the 2012 and 2014 CLDS data,this paper tests the effect and mechanism of Urban-rural Integrated Medical Insurance System on the health of residents aged 15 to 64,using a dual differential regression model.The results show that the System is beneficial to the residents’health,to reduce the negative effects of poor health on work,and to improve the self-rated health status.The effects differ for urban and rural residents,and it is greater for rural residents than for urban ones.The associated mechanism for rural residents goes through reducing the incidence of not seeking medical treatment when sick,and alleviating the extent of work absence for health reasons.The positive effect for urban residents is mainly to improve the self-rated health.Although the System has a positive effect on health improvement,it is unable to reduce the prevalence of illnesses.Therefore,we should make efforts to change the behavior of medical treatment,reduce the prevalence of illnesses,and take active treatment when sick.