新农保养老金能否缓解农村家庭医疗支出负担?——基于政策效果评估视角

Can Rural Pension Alleviate Family Health Expenditure Burden in China?——Policy Evaluation of New Rural Pension Scheme

一般来说,减缓农村家庭过重医疗负担的路径有二,提高医保共付水平和家庭支付能力。当前中国医疗保险保障水平较低,仅依靠医保不足以缓解农村家庭过重的医疗负担,于是转而关注“新农保”养老制度,能否提高家庭支付能力从而起到“意外的”缓解医疗负担的作用。基于中国健康与养老追踪调查CHARLS2018的微观数据,本文利用断点回归方法实证探究了“新农保”养老金对农村家庭医疗支出负担的缓解作用。研究结果显示,领取了新农保养老金的个人其家庭的医疗支出负担显著降低了约11.6%-14.2%,灾难性医疗支出发生率也减少了约12.8%-15%,并且这种缓解作用对低收入家庭更为有效。通过了四种有效性检验,充分证明了结论的稳健性。结果显示了我国社会保障体系的整合型特点,为“新农保”政策的效果评估提供了新的研究视角和经验证据。

Generally there are two ways to alleviate the excessive medical expenditure burden of rural families:improving the level of medical insurance sharing and improving the ability of families to pay.At present,the level of medical insurance in China is not sufficient,and the medical expenditure burden of rural families is still heavy.Therefore,whether the existing“New Rural Pension Scheme”(NRPS)can improve the ability of families to pay and thus“unintentionally”relieve the health expenditure burden is worth further discussion and evaluation.This paper empirically explores this alleviating effects by using regression discontinuity design(RD)method with CHARLS 2018 data.Our research found that receiving pension from NRPS can significantly reduce the proportion of out-of-pocket(oop)to family yearly income by about 11.6%-14.2%and reduce the incidence of catastrophic medical expenditure(CHE)by about 12.8%-15%.Besides,we found this alleviating effect is more significant in low-income families.Contrasted with family size,self-rated health,chronic disease and self-care ability of family members have a greater impact on the burden of family health expenditure.After passing four validity tests,this paper proves the robustness of the results and provides a new research perspective and empirical evidence for the effect evaluation of“New Rural Pension Scheme”.