新医改以来政府医疗支出对个人医疗支出的影响研究——来自中国家庭追踪调查数据的经验证据

Research on the Influence of Government Medical Expenditure on Individual Medical Expenditure Since the New Medical Reform——Empirical Evidences from China Family Panel Studies Data

新医改强化了政府在医疗卫生领域的责任,政府医疗支出持续增加。而新医改以来不断增加的政府医疗支出对个人医疗支出产生了怎样的影响是值得探究的问题。利用中国家庭追踪调查(CFPS)数据对新医改以来政府医疗支出对个人医疗支出的影响进行实证分析。结果表明:新医改以来政府医疗支出对个人医疗支出具有明显的“挤入”效应,农村和低收入阶层的“挤入”效应更为明显。个人医疗支出增加一方面来自新医改对个人医疗消费需求的“释放效应”,另一方面则是医疗负担上升造成的“增负效应”。新医改有效缓解了“看病难”问题,但“看病贵”问题仍旧存在。为此,应优化政府医疗支出结构,创新政府医疗投入方式,建立向弱势群体倾斜的大病医保制度。

The new medical reform strengthens the government's responsibility on health care,and the government medical expenditure has continued to increase.How the increasing government medical expenditure affects the individual medical expenditure since the new medical reform is worth exploring.This paper uses China Family Panel Studies(CFPS)data to explore the impact of government medical expenditure on individual medical expenditure.The result shows that since the implementation of the new medical reform,the government medical expenditure has a significant"Crowding-in-Effect"on individual medical expenditure,and the"Crowdingin-Effect"is more obvious in rural area and low-income group.On the one hand,the increase of personal medical expenditure comes from the"release effect"of the new medical reform on personal medical demand,on the other hand,it is the"burden increasing effect"caused by the increase of personal medical burden.The new medical reform has alleviated the problem of"difficult medical treatment",but the problem of"high medical expense"is still exists.Therefore,we should optimize the government medical expenditure structure,innovate the way of government medical expenditure,establish a serious illness medical insurance system that favors vulnerable group.