城镇职工基本医疗保险与城镇职工资产结构动态演进

Basic Medical Insurance and the Dynamic Evolution of Asset Structure of Urban Workers

家庭作为社会经济活动的基本单位,其收入、消费以及资产配置行为会对社会经济活动产生深远影响,因此社会医疗保险如何影响家庭资产结构就成为值得关注的问题。本文首先基于生命周期理论建立包含健康风险与健康保险的理论模型,研究工作阶段与退休阶段健康风险以及城职保对个体收入序列、消费序列及资产序列的影响,并进行数值模拟,研究发现损失概率、损失程度、免赔率以及城职保运行成本会降低个体收入和消费,增加工作阶段资产并降低退休阶段资产;企业承担比例会促进收入、消费增加,降低工作阶段资产并增加退休阶段资产。其次,运用2015—2019年的CHFS数据进行检验,基准回归证实了健康风险会降低家庭的收入、消费,提高工作阶段资产水平并降低退休阶段资产水平,城职保则会对收入和消费的下降进行弥补,但会降低工作阶段资产水平并提高退休阶段资产水平,上述关系会伴随时间发生变化,但总体影响方向不变。联立方程回归则发现家庭当期资产与当期收入呈现正相关,与当期消费负相关,从而健康风险与城职保可以促进家庭资产结构的动态演进。最后,本文提出要促进基本医疗保险进一步整合,进一步完善基本医疗保险的保障规范,可以对不同的参保人群设置有针对性的保障措施。

As the basic unit of social and economic activities,family income,consumption and asset allocation behavior will have a profound impact on social and economic activities.Therefore,how social medical insurance affects family asset structure has become a concern.Firstly,based on the life cycle theory,we establish a theoretical model including health risk and health insurance,study the impact of basic medical insurance and health risk on individual income sequence,consumption sequence and asset sequence in the working stage and retirement stage,and conduct numerical simulation.We find that the probability of loss,the degree of loss,the deductible rate and the operating cost of basic medical insurance will reduce individual income and consumption,increase the assets in the working stage and reduce the assets in the retirement stage.The proportion of enterprises will increase income consumption,reduce working-stage assets and increase retirement-stage assets.Secondly,the CHFS data from 2015 to 2019 are used for testing.The benchmark regression confirms that health risks will reduce household income and consumption,increase the level of assets in the working stage and reduce the level of assets in the retirement stage.basic medical insurance will make up for the decline in income and consumption,but it will reduce the level of assets in the working stage and increase the level of assets in the retirement stage.The above relationship will change with time,but the overall impact direction will remain unchanged.The simultaneous equation regression finds that the current capital of the family is positively correlated with the current income and negatively correlated with the current consumption,so that health risks and basic medical insurance can promote the dynamic evolution of the family asset structure.Finally,we propose to promote the further integration of basic medical insurance and further improve the protection norms of basic medical insurance,and set targeted protection measures for different insured people.