中国社会医疗保险中的逆向选择行为:基于CHNS 2009年和2011年数据的实证检验

Adverse Selection in China’s Social Health Insurance:Empirical Analysis Based on CHNS 2009 and 2011

本文基于医疗保险的信息经济学理论,对中国社会医疗保险体系中是否存在逆向选择进行实证检验。基于中国健康与营养调查(CHNS)2009年和2011年的数据和Logit模型进行分析,本文发现:逆向选择在公立的社会医疗保险中的确有可能存在,但其存在性具有不确定性;逆向选择有可能随着政府补贴水平提高、保险给付结构改善以及保险制度建立的时间延续而降低。这说明,保险项目的制度完善对于阻遏逆向选择是至关重要的,而社会医疗保险在参保人当中所产生的学习效应也有缓解逆向选择之效。

The article focuses on the adverse selection problem in China’s social health insurances system. Based on empirical results by quantitative analysis of data from the CHNS 2009 and 2011 survey, the findings are include:(1) adverse selection exists in China’s social health insurance schemes, yet the existence is uncertain;and(2) adverse selection could be eliminated by higher governmental subsidies, improved insurance policy or the consolidation of the schemes. The article concludes with a policy advice, stressing the importance of institutional design and the self-learning effects by the participants of the insurance schemes.