重大慢性病与中国老年家庭财产消耗——兼论保险的调节效应

Major Chronic Diseases and Wealth Depletion in Chinese Elderly Households:A Concurrent Discussion on the Moderating Effects of Insurance

家庭财产抵御或抗击风险的能力对老年家庭的财务安全至关重要。本文基于中国健康与养老追踪调查(CHARLS)2011~2018年的平衡面板数据,分析了重大慢性病(中风、心脏病、癌症、肺病、糖尿病)对老年人财产消耗的影响。研究发现,在2011~2018年期间,新发重大慢性病显著提高了老年人财产消耗的概率,增加幅度约为3个百分点。城乡差异分析显示,这一效应主要体现在农村老年群体中,而对城镇老年群体并无显著影响。具体而言,在样本期内,遭受重大慢性病将显著降低西部地区及除直辖市、副省级城市和省会城市以外地区的农村老年人财产水平。针对农村老年群体的异质性分析表明,重大慢性病对人均财产处于25分位点以下的老年人,造成了显著的财产消耗,负面影响主要集中在受教育程度较低、男性及低龄老年人中。机制和调节效应分析结果显示,医疗卫生支出占可支配收入的比重超出灾难性卫生支出的界限是导致农村老年人财产消耗的重要原因。此外,多层次医疗保障尤其是商业医疗保险和养老保险能缓解重大慢性病对城镇老年人财产状况的负面影响,但对农村老年人的支持却较为有限。研究结果可为防止返贫和降低老年人经济风险提供借鉴。

The capacity of household wealth to withstand risks is critical for the elderly.Based on the China Health and Retirement Longitudinal Study(CHARLS)balanced panel data from 2011 to 2018,this paper analyzes the impact of major chronic diseases(including stroke,heart disease,cancer,lung disease,and diabetes)on the wealth consumption of older adults.The findings reveal that newly emerged major chronic diseases significantly increase the likelihood of wealth consumption by approximately 3%,primarily affecting rural elders,with minimal impact on their urban counterparts.This effect is particularly pronounced among rural elders in the western regions and the elderly people in areas other than the central-controlled municipalities,sub-provincial cities and provincial capitals.The heterogeneity analysis indicates that this is especially true for those with wealth below the 25th percentile,whose wealth consumption accounts for 40%-50%of their initial wealth.The negative impact is more pronounced among less educated,younger,and male rural elders.The mechanism and moderating effect study identifies that the percentage of medical and health expenditures in total disposal income exceeding the catastrophic health expenditure thresholds is a key driver of asset depletion among rural elders.Although multi-level medical insurance,especially commercial medical insurance and pension schemes can alleviate negative effects for urban elders,their benefits for rural elders remain limited.This research offers some significant policy suggestions for addressing poverty relapse and mitigating economic risks among the elderly population.