商业补充医疗保险对农村家庭贫困脆弱性的影响

The impact of commercial supplementary medical insurance on the poverty vulnerability of rural households

以农村家庭为研究对象,评估商业补充医疗保险对农村家庭贫困脆弱性的影响。研究发现:拥有商业补充医疗保险使农村家庭贫困脆弱性发生率显著降低1.88%;在更换贫困脆弱性阈值和家庭商业补充医疗保险参保率指标两种情形下,实证结果仍然具有稳健性;考虑商业补充医疗保险参保过程中的选择性偏差,倾向得分匹配估计发现内生性问题影响小;机制检验发现,商业补充医疗保险发挥了费用补偿机制的同时,抑制了医疗费用对家庭消费支出的挤出,防止家庭未来陷入贫困。在缴费水平方面,建立水平适度并具激励性的定价机制;在报销范围方面,商业补充医疗保险应与社会医疗保险形成有益补充;在参保模式方面,作为补充性质的保险,商业补充医疗保险未必具有强制参保特征。

Taking rural households as the research object,this paper evaluates the impact of commercial supplementary medical insurance on the vulnerability to poverty of rural households.The study found that having commercial medical insurance as a supplementary insurance significantly reduced the extent of vulnerability to poverty of rural households by 1.88%;however,the empirical results are still robust in the case of replacing the poverty vulnerability threshold by the household commercial medical insurance coverage.Considering the selection bias in the process of enrollment to the commercial supplementary medical insurance,the propensity score matching estimates found that the impact of the endogenous problem is less significant.The mechanism test results showed that while commercial supplementary medical insurance played a very significant role in the cost compensation mechanism,at the same time,it suppressed the extrusion of medical expenses on household consumption expenditures,and prevented households from falling into poverty in the future.In terms of payment level,it is concluded that the pricing mechanism with moderate level and incentive should be established.In the aspect of reimbursement scope,commercial supplementary medical insurance should form a beneficial supplement with social medical insurance.As a supplementary insurance,commercial medical insurance is not necessarily compulsory.