管理评论

管理评论 ›› 2023, Vol. 35 ›› Issue (5): 19-28,65.

• 经济与金融管理 • 上一篇    下一篇

社会医疗保险的长期消费平滑及事前道德风险影响：来自新农合的证据

王吉元1, 高雅2, 胡毅3   

  1. 1. 中央财经大学保险学院, 北京 102206;
    2. 威尼斯大学经济学院, 威尼斯 30123;
    3. 中国科学院大学经济与管理学院, 北京 100190
  • 收稿日期:2021-12-03 出版日期:2023-05-28 发布日期:2023-06-21
  • 通讯作者: 胡毅（通讯作者），中国科学院大学经济与管理学院教授，博士生导师，博士。
  • 作者简介:王吉元，中央财经大学保险学院助理教授，博士；高雅，威尼斯大学经济学院助理教授，博士。
  • 基金资助:
    国家自然科学基金项目（72204282；72073124）；教育部人文社会科学重点研究基地基金项目（22JJD790092）；中国科学院大学数字经济监测预测预警与政策仿真教育部哲学社会科学实验室（培育）基金项目。

Long-term Consumption Smoothing and Ex Ante Moral Hazard Effects of Social Medical Insurance:Evidence from the New Cooperative Medical Scheme Implementation

Wang Jiyuan1, Gao Ya2, Hu Yi3   

  1. 1. School of Insurance, Central University of Finance and Economics, Beijing 102206;
    2. Department of Economics, Ca' Foscari University of Venice, Venice 30123;
    3. School of Economics and Management, University of Chinese Academy of Sciences, Beijing 100190
  • Received:2021-12-03 Online:2023-05-28 Published:2023-06-21

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摘要： 社会基本医疗保险是我国社会保障制度的重要组成部分，能够缓解人民就医困难问题并增进人民福祉。新型农村合作医疗保险作为我国重要的基本医疗保险之一推出已达十年之久，研究其对农村人口的长期影响非常必要。本文基于中国健康与养老追踪调查（CHARLS）2011年、2013年和2015年的数据，构建双重差分模型，研究了我国新型农村合作医疗保险对个体的长期消费平滑和事前道德风险行为影响。具体来看，本文识别了新型农村合作医疗保险对个体消费增长、事前道德风险行为、健康水平和医疗服务支出的长期影响。结果发现：（1）新农合有维持家庭的长期消费平滑的效果，新农合保障力度越强、个体参保时间越长，长期的消费平滑效应也越强；（2）长期来看，作为基本医疗保险，新农合带来的道德风险行为并不显著，同时对家庭财务增长的影响也不显著；（3）新农合能够显著减少个体医疗服务费用支出。

关键词: 新型农村合作医疗保险, 消费平滑效应, 事前道德风险, 健康, 长期影响

Abstract: Social basic medical insurance is a major component of social security system in China. It mitigates residents' difficulties of receiving medical treatment and improves their welfare. As one of the most important parts of social basic medical insurance programs, the New Cooperative Medical Scheme has been launched for more than ten years. Evaluating the impacts of this program on Chinese rural residents is very necessary. This paper studies the long-term impacts of the New Rural Cooperative Medical Insurance on consumption smoothing and ex ante moral hazard behaviors of Chinese rural residents. By employing a Difference-in-Differences design and the China Health and Retirement Longitudinal Study (2011, 2013, 2015) data set, this paper identifies the long-term effects of exposure to the New Rural Cooperative Medical Insurance on individual consumption growth, ex-ante moral hazard behaviors, health status and medical expenditures. The results show that, firstly, the long-term consumption smoothing effect is stronger on individuals who live in areas with higher insurance contribution levels and who enjoy longer enrollment periods. Secondly, as a basic insurance program, the New Rural Cooperative Medical Insurance has little ex-ante moral hazard effects, and it also has an insignificant impact on household financial growth. Thirdly, the New Rural Cooperative Medical Insurance decreases medical expenditures in the long run.

Key words: New Rural Cooperative Medical Insurance, consumption smoothing effects, ex-ante moral hazard, health, long-term effects