城乡居民基本医疗保险的减贫效应研究--基于贫困脆弱性视角的实证分析

Research on the Poverty Reduction Effect of Urban and Rural Residents'Basic Medical Insurance--An Empirical Analysis Based on the Perspective of Poverty Vulnerability

目的:考察城乡居民基本医疗保险的减贫效应,为政府制定和完善城乡居民医疗保障制度提供参考和依据。方法:采用中国健康与养老追踪调查(CHARLS)2018年的横截面数据,以45岁以上农村居民为研究对象,使用工具变量法实证分析城乡居民基本医疗保险对贫困脆弱性的影响及其群体异质性。结果:城乡居民基本医疗保险使农村中老年群体的贫困脆弱性显著降低了3.04%;城乡居民基本医疗保险在老年组、低收入组和高医疗支出组中更能发挥减贫作用。结论:城乡居民基本医疗保险发挥了良好的减贫效应;建议从拓宽筹资来源、关注重点人群、提高补偿水平、严控风险发生等方面完善城乡居民基本医疗保险,使其更好地发挥减贫效应。

Objective To investigate the poverty reduction effect of the basic medical insurance system for urban and rural residents,and provide reference and basis for the government to formulate and improve the medical insurance system for urban and rural residents.Methods Using the cross-sectional data of China Health and Retirement Longitudinal Study(CHARLS)in 2018,taking rural residents over 45 years of age as the research object,this study used poverty vulnerability indicators to measure individual poverty risk,and used instrumental variable method to empirically analyze the impact of urban and rural residents'medical insurance on poverty vulnerability and its group heterogeneity.Results The empirical analysis results showed that participating in the medical insurance for urban and rural residents significantly reduced the poverty vulnerability of the rural middle-aged and elderly groups by 3.04%.Heterogeneity analysis found that the medical insurance system for urban and rural residents was more effective in reducing poverty in the elderly group,low-income group,and high medical expenditure group.Conclusions Medical insurance for urban and rural residents has exerted a good poverty reduction effect,enabling people with high medical needs to benefit more from it,and medical insurance has a good effect on poverty alleviation.It is recommended to expand funding sources,focus on key populations,increase compensation levels,and strictly control risk occurrence so as to make improvements to better bring out the poverty reduction effect of urban and rural residents'medical insurance.