大学生参加城镇居民基本医疗保险激励机制设计

Breaking through Voluntary Predicament:Design of Incentive Mechanism for College Students’ Insurance

基于问卷调查数据,运用卡方检验分析大学生参加城镇居民基本医疗保险的影响因素,并运用logistic回归分析检验大学生参保逆向选择是否存在,进而为提高大学生自愿参保率提供政策建议。研究发现,大学生参保存在逆向选择行为:大学生群体中身体健康较差、过去一年发生医疗费用较多的同学更倾向于参保;另外,识别了大学生参保的显著性影响因素:人口社会学(户口类型、所在年级、主修专业)、政策宣传、医疗服务供给水平。建议从加强大学生医保政策宣传、建立隐性强制参保机制、提升基层医疗资源配置和服务水平、考虑设计差别费率的保单几个方面提高大学生自愿参保率。

Based on the questionnaire survey data,we use Chi-square test to analyze the influencing factors of college students’ participation in basic medical insurance for urban residents,and use logistic regression analysis to test the existence of adverse selection of college students’ participation,thus providing policy recommendations for improving the voluntary participation rate of college students.The study find that college students have adverse selection behavior:students with poor health and more medical expenses in the past years are more likely to participate in the insurance.In addition,the significant influencing factors of college students’ participation in insurance are identified:demographical factors(type of registered permanent residence,grade,major),policy propaganda,and level of medical service supply.We suggest that the voluntary participation rate of college students in insurance should be increased from these aspects,including:strengthening the propaganda of medical insurance policies for college students,establishing a hidden compulsory enrollment mechanism,improving the allocation of primary medical resources and service level,and taking the design of policies with different rates into consideration.