新型农村合作医疗保险对农村中老年人照料孙子女的影响

The Impact of New Rural Cooperative Medical Insurance on the Care of Grandchildren from Rural Middle-aged and Elderly People

中国新型农村合作医疗保险对参保群体的健康和医疗费用具有直接影响,但其是否存在明显的"溢出效应"却较少被讨论。利用中国健康与养老追踪调查数据,本文分析了新农合对农村中老年人照料孙子女的影响及这种影响的作用渠道。研究结果表明,参加新农合显著提高了农村中老年人照料孙子女的概率,增加了其照料孙子女的强度。进一步分析显示,新农合在促进农村中老年人照料孙子女上呈现出明显的异质性,主要表现为:新农合对农村男性、中年人照料孙子女概率和强度的影响比对女性和老年人的影响更加显著。此外,作用渠道的分析表明:新农合之所以能够促进农村中老年人对孙子女的隔代照料,主要是新农合的"健康效应"和"财富效应"起了决定性作用,即新农合通过改善农村中老年人健康水平和财富水平进而间接带动了照料孙子女概率和强度的增加。也就是说,新农合在对参保农村中老年人产生健康和医疗费用方面直接影响的同时,也带来了明显的"溢出效应";"溢出效应"的存在不但减轻了农村家庭的抚育负担,更提高了农村儿童的福利水平。

China’s new rural cooperative medical insurance has a direct impact on the health and medical expenses of the insured groups, but whether there is an obvious "spillover effect" is less discussed. Based on the data of CHARLS, this paper analyzes the impact and its mechanism of NCMS on the care of grandchildren from rural middle-aged and elderly people. The results show that participating in NCMS significantly increased the probability and the intensity of caring for grandchildren from rural middle-aged and elderly people. Further analysis shows that NCMS has obvious heterogeneity in promoting the care of grandchildren in rural middle-aged and elderly people. The main manifestations are: the impact of NCMS on the probability and intensity of caring for grandchildren from rural males and middle-aged people is more pronounced than rural females and aged people. In addition, the channel of action indicates that the reason why NCMS can promote the intergenerational care of the grandchildren in rural middle-aged and elderly people is mainly that the "health effect" and "wealth effect" of NCMS, which has indirectly led to an increase in the care of grandchildren through improving the health and wealth of rural middle-aged and elderly people. That is to say, while NCMS has a direct impact on the health and medical expenses of the insured rural middle-aged and elderly people, it has also brought a significant "spillover effect". The "spillover effect" not only alleviates the burden of raising children in rural families, but also improves the welfare of rural children.