基本医疗保险制度的幸福效应

The Happiness Effect of the Basic Medical Insurance System

基于2011年和2014年中国老年健康影响因素跟踪调查数据,聚焦65岁以上城镇非职工老年群体,采用工具变量方法实证检验了基本医疗保险制度对老年人主观幸福感的影响,并进一步探究了群体异质性和影响产生的机制。研究发现:参保城镇居民基本医疗保险可以显著提升城镇老年人的主观幸福感,其中,显著降低老年人的消极情感,促进积极情感的产生;幸福感的提升作用在低龄段、低收入、健康状况较好的老年群体中体现得更加明显。进一步研究发现,参保城镇居民基本医疗保险对老年人主观幸福感的影响主要通过提升家庭收入水平来实现。由此,本文提出提升基本医疗保险制度作用的深度和力度,提高医疗保险基金灵活筹资和动态调整能力,增强商业健康保险的补充作用,将老年人单纯的医疗保障升级为全面的服务与精神保障等建议。

Based on the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)in 2011 and 2014,focusing on the elderly population with age over 65,this paper empirically analyzes the effect the of the basic medical insurance system on the subjective well-being of the urban elderly by using the instrumental variable method and tests population heterogeneity and the mechanism of the effect.The results show as follow:participating in the urban residents'basic medical insurance can significantly improve the subjective well-being of the urban elderly,in which the negative emotions can be significantly relieved and the positive emotions can be enhanced;the improvement of the subjective well-being is more obvious for the elderly group with low age,low income and better health.Further study finds that the effect of urban residents'basic medical insurance on the subjective well-being of the elderly is mainly achieved by raising income levels.Therefore,this paper proposes to enhance the depth and strength of the basic medical insurance system,improve the flexible financing ability and dynamic adjustment ability of the medical insurance fund,enhance the complementary role of commercial health insurance,and upgrade the simple medical security of the elderly to comprehensive service and spiritual security.