农民工的医保选择研究——基于中国乡城人口流动调查数据的分析

Migrant Workers’Choice of Medical Insurance:An Empirical Analysis Based on RUMiC Data

本文基于2016年和2017年中国乡城人口流动调查数据,对农民工参与户籍地居民医保和务工地职工医保的关系进行研究。通过加入个人固定效应,使用在就业地同住的其他家庭成员参加居民医保的情况作为工具变量,本文发现农民工参加居民医保会降低职工医保参保概率的11.6%,挤出效应显著并且稳健。挤出效应主要集中在没有签订长期或永久劳动合同、自营单位或保险费用全由自己承担的农民工群体,这三类农民工不仅更可能被企业逃避社保缴纳责任,且收入不固定,很可能选择放弃社会保障获得更高的收入。参加居民医保的农民工对职工医保的支付意愿更低,且农民工对职工医保的支付意愿的平均值和中值都远低于实际需支付的保费。

Using the 2016 and 2017 Rural-Urban Migration in China(RUMiC)data,we study the choice of health insurance among migrant workers:Residence-Based Medical Insurance(RBMI)or Urban Employment-Based Medical Insurance(UEBMI).Using a Two-Stage least squares model with individual fixed effects and treating the probability of family member participating in UEBMI as an instrumental variable,we find that migrants’participation in RBMI reduces their probability of using UEBMI by 11.6 percent.The reduction,or crowding-out effect,is significantly larger for those without long-term or permanent labor contracts,working self-employed,or paying insurance costs all by themselves.We also find the willingness to pay for UEBMI is lower for migrant workers having RBMI,and the amount that they are willing to pay for UEBMI is also much lower than the actual insurance premium per year.