老年照护保障与家庭消费——基于长护险试点的政策效应评估

Old-age Care Security and Family Consumption:Evaluation of Policy Effect Based on Long-term Care Insurance Pilot

长期护理险试点是中国积极应对老龄化、健全社会保障体系的重要实践。引入长期护理险的理论模型对家庭消费行为进行分析,采用中国养老与健康追踪调查(CHARLS)2011—2018年4期面板数据,以长期护理险试点作为准自然实验,运用双重差分法评估长期护理险试点对家庭消费的政策效果。研究发现:长期护理险试点促进了家庭消费,改善了家庭消费结构;作用机制检验表明,长期护理险通过影响家庭劳动参与率、非医疗消费和预防性储蓄三个渠道影响家庭总消费;异质性检验结果显示,长期护理险试点对中低收入家庭、独生子女家庭以及有重度失能老人家庭的消费提振作用更为明显。因此,应有序扩大长期护理险试点范围和支付范围,加大社区护理和居家护理服务力度等,为积极应对老龄化以及推动内循环为主、双循环互促的发展战略提供政策参考。

Insufficient domestic demand has persistently hindered China’s macroeconomy,a challenge exacerbated by the deepening aging of our population and the resulting financial strain of supporting the elderly.This has fostered precautionary saving motives among households,constraining overall consumption.Addressing the cost of alimony payments,alleviating elderly concerns,and unlocking consumption potential are pivotal issues drawing attention from both the government and academic circles.In response to the rapidly aging population and escalating pressure for home care,the Long-Term Care Insurance(LTCI)has emerged at an opportune time.Existing studies primarily focus on the political implications of LTCI,lacking an examination of its impact on household consumption at the micro-household level.Understanding the internal action mechanism remains underexplored.This article adopts a theoretical model integrating LTCI to investigate its effects on household consumption.Leveraging four years of panel data from the China Health and Retirement Longitudinal Study(CHARLS)spanning 2011-2018,we utilize the pilot of the long-term insurance system as a quasi-natural experiment.Employing the Difference-in-Differences(DID)method,we evaluate the policy effect of the LTCI pilot on household consumption.Our findings indicate that the LTCI pilot stimulates household consumption and enhances the consumption structure.A mechanism test reveals that LTCI affects household consumption through three primary channels:labor participation rate,non-medical consumption,and preventive savings.Heterogeneity analysis underscores that LTCI has a notably pronounced boosting effect on the consumption of low-and middle-income families,single-child families,and families grappling with severe disabilities.Compared to prior literature,this article’s main contributions lie in utilizing a theoretical model to analyze the effect of LTCI on household consumption and presenting relevant propositions.We capitalize on LTCI’s policy impact,utilizing the DID model to corroborate these propositions and enriching the study of the bonus policy by LTCI.Moreover,our empirical testing scrutinizes the promotion effect on household consumption through household labor participation,non-medical consumption,and precautionary saving.The results furnish evidence affirming the relationship between formal care and household consumption.Lastly,we investigate LTCI heterogeneity by family characteristics.In conclusion,this article investigates the internal mechanism between LTCI and household consumption,establishing that LTCI effectively boosts household consumption through increased labor participation,non-medical consumption,and precautionary saving.The econometric model substantiates our propositions.These findings offer valuable policy insights for enhancing the long-term insurance system,alleviating elderly concerns,stimulating resident consumption,and informing government strategies in response to demographic transitions and the dual-cycle development pattern driven by domestic demand.