从新型农村合作医疗到城乡居民基本医疗保险:城乡医保统筹的政策效应分析

From New Rural Cooperative Medical Insurance to Basic Medical Insurance for Urban and Rural Residents:An Analysis of Policy Effects of the Urban-Rural Medical Insurance Coordination System

关于社会医疗保险的研究已有很多,但针对城乡医保统筹的研究仍显不足。本文基于CFPS2014年和2016年的两期面板数据,采用双重差分方法识别城乡医保统筹对参保农民医疗服务利用率、总医疗费用、自付医疗费用、自评健康和客观健康的影响。研究发现:(1)城乡医保统筹显著提高参保农民的医疗服务利用率、总医疗费用、自付医疗费用、自评健康和客观健康;(2)城乡医保统筹对高收入群体、老年群体和患病群体的影响较大,而对低收入群体、年轻群体和健康群体的影响较小甚至不显著。这些研究发现对城乡医保统筹的实施和完善具有重要的政策意义。

Many studies on social and medical insurance have been conducted, but the study of the urban-rural medical insurance coordination system is still scant. Using the two-phase panel data of CFPS in 2014 and 2016, this paper establishes a differences-in-differences model to identify effects of the system on medical service utilization rates, total medical expenses, out-of-pocket medical expenses, self-rated health, and objective health of insured farmers. The findings are as follows:(1) the system significantly improves medical service utilization rates, total medical expenses, out-of-pocket medical expenses, self-rated health, and objective health of insured farmers.(2) the effects of the system are more substantial for groups of high-income, the elderly, and the sick, while effects are weaker or nonsignificant for groups of low-income, the young, and the healthy. These findings have important policy implications for the system.