医疗保险对农民工落户意愿的双重影响:“推拉效应”和“替代效应”——基于2017年全国流动人口动态监测数据的实证检验

Double effects of medical insurance on migrant workers’willingness to settle down in cities:“push pull effect”and“substitution effect”——Empirical study on the dynamic monitoring data of the floating population in China in 2017

医疗保险作为一种基本的社会保障资源,是流动人口在城市落户的重要资本,影响着农民工群体的城市落户意愿。利用国家卫生计生委发布的2017年全国流动人口动态监测调查数据,建立最小二乘法模型,分析医疗保险对农民工群体城市落户意愿的影响。研究发现:第一,新型农村基本合作医疗对农民工落户城市具有显著“推力”,城镇职工基本医疗保险对农民工落户具有明显“拉力”。第二,城镇职工基本医疗保险的“拉力”作用高于新型农村合作医疗的“推力”作用;在考虑个人、家庭、社会特征的情况下,城镇职工基本医疗保险对农民工群体落户意愿的“拉力作用”会完全替代基本医疗保险对农民工群体落户意愿的“推力作用”,产生“替代效应”。第三,年龄、健康状况、受教育水平、家庭月均收入、住房性质和社交活动也会影响农民工的城市落户意愿。为提高农民工城市落户意愿,推动农民工市民化顺利进行,需要加大制度宣传力度、降低医保制度门槛、完善医保制度异地转接工作、整合医保制度。

As a basic social security resource,medical insurance is an important capital for the floating population to settle in the city,which affects the migrant workers’willingness to settle in the city.In this paper,using the national floating population dynamic monitoring survey data in 2017 released by National Health and Family Planning Commission,the least square method model was established to analyze the impact of medical insurance on migrant workers’urban settlement willingness.The results show that:First,the new rural basic cooperative medical system has a significant“pusheffect”on migrant workers’settling in the city,and the basic medical insurance for urban workers has an obvious“pull effect”on the settlement of migrant workers.Second,the“pulling effect”of the basic medical insurance for urban workers is higher than that of the“push effect”of new rural cooperative medical system.Considering the individual,family and social characteristics,the“pull effect”of the basic medical insurance on the settlement intention of the migrant workers will completely replace the“push effect”of the basic medical insurance on the settlement intention of the migrant workers,resulting in the“substitution effect”.Third,age,health status,education level,family monthly income,housing nature and social activities also affect migrant workers’willingness to settle in the city.In order to improve the willingness of migrant workers to settle down in cities and promote the smooth citizenization of migrant workers,it is necessary to make policy adjustments such as increasing the publicity of the system,lowering the threshold of the medical insurance system,improving the work of transferring the medical insurance system from other places,and integrating the medical insurance system.