数字化、农户医保参与和城乡健康受益公平

摘要基于2019年中国家庭金融调查数据,采用OLS、Logit模型和3SLS等多重方法考察支付数字化对农户医保参与的影响并探讨二者在促进城乡健康受益公平中的作用。结果表明:第一,支付数字化显著促进了农村户籍人口的医保参与,且对老龄人口和转移就业农户医保参与的促进作用更为显著。第二,支付数字化能够缓解医保参与中的信息不对称、提高农户医保参与可获得性和健康素养,进而提高其医保参与意愿。第三,支付数字化缩小了城乡健康差距,有助于实现城乡健康受益公平;医保参与和医疗可及性是支付数字化促进城乡健康受益公平的程序路径,但同时考虑新型农村合作医疗保险和城乡居民基本医疗保险条件下的医保参与反而加剧了城乡健康不平等,仅考虑城乡居民基本医疗保险情境下的医保参与展现出更好的公平性,揭示了城乡居民医保整合并轨的重要性。第四,支付数字化对农户的商业医疗保险参与同样存在收入效应,说明中国当前的社会医疗保险和商业医疗保险具有互补性质。基于上述结论,有必要全面提高农村地区数字化水平,积极推动医保参与和变更线上办理;同时,应加快推进城乡居民医保整合,实现城乡医疗保险服务均等化。

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	韦钦文
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关键词：支付数字化医保参与健康受益公平医疗可及性

Abstract： Based on data from the 2019 China Household Finance Survey, the paper uses multiple methods such as OLS, Logit Model and 3SLS to examine the impact of payment digitalization on farmers’ medical insurance participation and explore the role of the two in promoting equity of urban and rural health benefits. The results indicate the following: Firstly, the digitization of payments has significantly increased medical insurance participation among rural residents, with a stronger promoting effect on the elderly population and rural migrant workers; Secondly, digitization of payments can alleviate information asymmetry in medical insurance participation, enhance the accessibility and health literacy of rural residents regarding medical insurance, and thereby increase their willingness to participate; Thirdly, digitization of payments narrows the urban-rural health gap, contributing to equitable health benefits between urban and rural areas. Medical insurance participation and access to healthcare services are procedural pathways through which digitization of payments promotes equitable health benefits. However, considering medical insurance participation under both the New Rural Cooperative Medical Insurance System and the Urban and Rural Residents Basic Medical Insurance System simultaneously exacerbates urban-rural health inequalities. In contrast, solely considering medical insurance participation under the Urban and Rural Residents Basic Medical Insurance System exhibits better equity, highlighting the importance of integrating these two systems; Fourthly, the digitization of payments also has an income effect on rural households’ participation in commercial medical insurance, demonstrating the complementary nature of China’s current social medical insurance and commercial medical insurance. Based on the aforementioned conclusions, it is necessary to comprehensively enhance the level of digitization in rural areas and actively promote online processing for medical insurance participation and changes. Additionally, it is imperative to accelerate the integration of medical insurance for urban and rural residents, thereby achieving equalization of medical insurance services between urban and rural areas.

Keywords： Digitization of Payments Medical Insurance Participation Equity of Health Benefits Medical Accessibility

收稿日期 2024-04-11; 接受日期 ;

基金资助:国家社会科学基金项目(17BJL081);国家资助博士后人员研究计划(GZC20233085)

作者简介: 韦钦文(1988— ),男,江苏南通人,博士研究生,主要从事创新经济学研究;张永峰(1992— ),男,湖北咸宁人,在站博士后,主要从事发展经济学研究;路瑶(1978— ),女,江苏射阳人,博士,副教授,主要从事转型经济学研究。张永峰为本文通信作者。

引用本文:

韦钦文, 张永峰, 路瑶.数字化、农户医保参与和城乡健康受益公平[J]. 经济经纬, 2024,5: 53-64

WEI Qinwen, ZHANG Yongfeng, LU Yao.Digitalization, Farmers’ Participation in Medical Insurance and Equity in Urban and Rural Health Benefits[J] Economic Survey, 2024,V41(5): 53-64

链接本文:

http://www.jjjw.org.cn/CN/ 或 http://www.jjjw.org.cn/CN/Y2024/V41/I5/53

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