新生儿未参保之谜:基本事实、成因及其影响

The Puzzle of Uninsured Newborns:Basic Facts,Cause and Consequences

中国已基本实现全民医疗保险覆盖,基本医疗保险参保率多年维持在95%以上,剩下的未参保人群成为真正实现全民医疗保险的“最后一公里”。精准识别未参保人群对于完善当前医疗保障制度具有重要意义。本文基于中国家庭追踪调查数据(CFPS),描述了大量新生儿未参加基本医疗保险的事实,并实证分析了参保率较低的原因及其对医疗服务利用的影响。描述性统计结果显示,新生儿参保率不足1/2,大大低于其他年龄阶段人群的参保率。进一步实证分析发现,父母不了解新生儿参保政策信息、基层组织缺乏向新生儿家庭宣传参保政策的激励是新生儿参保率低的主要原因。最后,考察未参保对新生儿医疗服务利用产生的影响,发现未参保状态显著降低了新生儿的医疗服务利用率。为了提高新生儿基本医疗保险参保率,政府一方面应针对性地加强新生儿医疗保险政策宣传,降低新生儿参保的信息障碍;另一方面应积极推动新生儿自动纳入基本医疗保障范围,甚至应考虑制定专门针对新生儿的医疗保健计划。

China has achieved universal coverage of medical insurance.More than 95%of people are now covered by the public medical insurance in China,and the remaining uninsured people become the last mile for achieving universal public medical insurance.Identifying uninsured people is important to improve efficiency of the current public medical insurance system.Based on the China Family Panel Studies Data(CFPS),this paper shows that large numbers of newborns are uninsured,and empirically explores the reason why there are so many uninsured newborns and its consequences.Descriptive statistics show that more than 50%newborns are uninsured.Further empirical analysis demonstrates that information friction of newborn parents and the grassroots organizations lack incentives to promote insurance policies to newborn families would be the main reasons.Finally,we examine the impact of uninsured on the utilization of medical services and the results show it significantly reduces the utilization of medical services for newborns.In order to increase the coverage of newborns public medical insurance,the government should on the one hand try to remove the information barriers to newborn families.On the other hand,the government can promote the automatic inclusion of newborns in public medical insurance,and even consider developing a medical care plan specifically for newborns.