新农合、灾难性医疗支出与贫困脆弱性

New Rural Cooperative Medical System,Catastrophic Medical Expenditure and Poverty Vulnerability

新农合制度在不同贫困标准下都能有效缓解农村居民贫困脆弱性,发生灾难性医疗支出时,该缓解作用随着贫困标准的提高而增强。新农合对不同收入居民的影响都很显著,灾难性医疗支出冲击下新农合对较高收入居民的影响系数大于低收入居民,存在逆向再分配。因此,我国应继续拓展新农合等医疗保障制度的可及性,减轻农村居民贫困脆弱性;加强医保对农村居民大病筛查常态化机制的支持,预防灾难性健康风险冲击;精准识别患病居民中相对贫困群体,运用倾斜性补偿改善逆向再分配;提高农村居民的医疗保障水平,促进公共卫生服务城乡均等化。

The new rural cooperative medical system can effectively alleviate the poverty vulnerability of rural residents under different poverty standards. When catastrophic medical expenditure occurs,the mitigation effect will increase with the increase of poverty standards. The new rural cooperative medical system has a significant impact on residents of different incomes. Under the impact of catastrophic medical expenditure,the coefficient of the new rural cooperative medical system on higher-income residents is greater than that of low-income residents,and there is reverse redistribution. It is recommended to continue to expand the accessibility and use of medical insurance systems such as the New Rural Cooperative Medical System to reduce poverty and vulnerability of rural residents;strengthen medical insurance to support the normalization mechanism of serious illness screening for rural residents to prevent catastrophic health risk impacts;accurately identify diseases among the relatively poor residents and use inclined compensation to improve reverse redistribution;improve the level of medical security for rural residents and promote the equalization of public health services between urban and rural areas.