统筹城乡居民大病保险制度效应研究

Study on the Effect of Critical Illness Insurance System for Urban and Rural Residents

本文构建了“健康需求-城乡统筹-健康公平”分析框架,使用贵州省两个市(州)的入户数据对大病保险制度效应进行了研究。结果表明,与身份相关的健康不平等得到了改善,与经济收入相关的健康不平等虽有所改善但存在不足;不同统筹模式制度效应的比较表明,统筹模式是健康公平的重要影响因素。从经济效应上看,“一元制模式”具有“富帮穷”“城帮农”的正向分配效应,“一制两档模式”存在着“穷帮富”的逆向分配效应。健康效应比较表明,两种统筹模式存在着与经济收入相关的健康不平等,“一制两档模式”的集中指数高于“一元制模式”。

The objective of this paper is to examine the different effects of integration models of Critical Illness Insurance(CII)on the urban and rural residents.This paper establishes an analytical framework of health demand—urban-rural integration—health equity,and studies the effect of CII using household data of two cities(states)in Guizhou Province.The empirical results show that the status-related health inequality has been improved;While the income-related health inequality has been improved,there are some shortcomings;The comparison of the system effects of different integration models shows that the integration model is an important factor affecting health equity;In terms of economic effect,the one-system model has the positive distribution effect of the rich help the poor and the urban help the rural,and the one-system-two-level model has the reverse distribution effect of the poor help the rich;The comparison of health effects shows that there are income-related health inequality between the two integration modes.The concentration index of one-system-two-level model mode is higher than that of"one-system model".This study provides a reference for policy improvement of CII.