大病保险的减贫效果研究——基于CFPS数据的实证分析

Research on the Poverty Reduction Effect of Critical Illness Insurance——An Empirical Analysis Based on CFPS Data

2012年起,中国各省市在城镇居民医疗保险和新型农村合作医疗保险的基础上开展了大病保险改革的政策试点。各省市政策推行存在时间差异,为评估大病保险对居民家庭产生的减贫效果提供了准自然实验的条件。本文采用中国家庭追踪调查(China Family Panel Studies, CFPS)微观入户调查数据,排除了整合城乡居民医疗保险的政策干扰,创新性地使用绝对贫困和相对贫困两个维度指标,利用双重差分方法研究了大病保险对家庭贫困指标的影响,并使用倾向匹配得分法进行稳健性检验,最后运用多时点DID进行拓展分析。研究结果表明:大病保险政策会显著降低家庭处于绝对贫困的可能性,一方面通过减少患者家庭医疗开支减轻了家庭经济负担,另一方面,大病保险间接提高了家庭的劳动参与,防止家庭因为大病冲击而彻底丧失劳动能力和经济收入,因此政策的减贫效应具有时间上的延续性。本文证明大病保险有效减少了因病致贫、因病返贫的现象,是保障脱贫成果的重要制度支撑。

Since 2012,local governments in China have gradually carried out a critical illness insurance policy pilot on the basis of the new rural cooperative medical insurance. Due to the time lag in the implementation of the policy in every province,a quasi-natural experimental environment has been formed to study the poverty reduction effect of the critical illness insurance on households. In this paper,China Family Panel Studies(CFPS) microscopic household survey data were used to study the impact of critical illness insurance on rural household poverty index by using the DID method,and the robustness test was conducted by using the PSM and TVDID method. The results show that the implementation of critical illness insurance significantly reduced the likelihood of families living in absolute poverty. On the one hand,critical illness insurance reduces the financial burden of the family by reducing the patient’s family medical expenses. On the other hand,critical illness insurance indirectly increases the family’s labor participation and prevents the family from completely losing work capacity and economic income due to the impact of a serious illness. The results prove that critical illness insurance is an important system support for guaranteeing the achievements of poverty alleviation by effectively reducing the phenomenon of poverty caused by illness.