通讯作者: 马琦峰, ruc_maslow@163.com

DOI：10.12201/bmr.202411.00011

Does Medical Insurance Cause Moral Hazard? ——Take Medical Insurance for Urban and Rural Residents as An Example

• 摘要：文章使用2005-2018年中国老年健康影响因素跟踪调查的五期平衡面板数据,使用双向固定效应模型,分析参加城乡居民医疗保险对老年人道德风险的影响。研究发现,首先,参加城乡居民医疗保险并不会引致老年人不健康行为增多的事前道德风险,但会带来医疗费用支出上涨的事后道德风险；其次,年龄越小、健康状况变差的老年人在参加城乡居民医疗保险后更易出现医疗费用支出上涨的事后道德风险；最后,相较于城镇居民医疗保险,老年人在参加新型农村合作医疗保险后更易出现医疗费用支出上涨的事后道德风险,参加城乡居民医疗保险引致的事后道德风险主要来源于门诊支出上涨。这启示我们：应清晰认识公共医疗卫生政策评估的多维属性,创新城乡居民基本医疗保险制度的发展理念。

  关键词： 城乡居民医疗保险; 参保老年人; 事前道德风险; 事后道德风险; 固定效应模型

   

  Abstract: This study utilizes balanced panel data from five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning 2005 to 2018 to analyze the impact of urban and rural resident medical insurance participation on moral hazard among older adults. The research findings are as follows: Firstly, participation in urban and rural resident medical insurance does not increase ex-ante moral hazard, such as unhealthy behaviors among older adults. However, it does result in ex-post moral hazard, indicated by a rise in medical expenditures. Secondly, younger seniors and those with deteriorating health conditions are more likely to experience increased medical expenses as an ex-post moral hazard after enrolling in the insurance. Lastly, compared to basic medical insurance for urban residents, older adults are more likely to experience increased medical expenses as an ex-post moral hazard after enrolling in the New Rural Cooperative Medical Scheme, primarily due to a rise in outpatient expenses. These findings highlight the need for a comprehensive understanding of the multi-dimensional attributes of public healthcare policy evaluation and innovate the development concept of the basic medical insurance system for urban and rural residents.

  Key words: Medical insurance for urban and rural residents; Older Adults; Ex-ante moral hazard; Ex-post moral hazard; Fixed effect model

  提交时间：2024-11-07

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 张航空, 马琦峰, 李慧慧. 城乡居民医保、老年人健康与医疗服务利用——来自五期CLHLS数据的证据. 2023. doi: 10.12201/bmr.202310.00005

  杜倩, 仇雨临. 基层政府创新及扩散研究——以整合城乡居民基本医疗保险政策为例. 2021. doi: 10.12201/bmr.202007.00027

  于凌云, 于梦迪. 城乡居民医保基金运行效率及其影响因素研究. 2021. doi: 10.12201/bmr.202109.00035

  王延中, 赵东辉. 新制度主义视角下城乡居民大病保险保障效果的影响因素分析. 2021. doi: 10.12201/bmr.202110.00038

  周德水, 党思琪. 商业健康保险对居民健康的影响* —来自CGSS数据的经验证据. 2021. doi: 10.12201/bmr.202108.00013

  王海平, 宁满秀. 城乡医保整合政策对农村中老年人医疗负担的影响. 2022. doi: 10.12201/bmr.202207.00035

  李 珍, 张 楚. 医保筹资. 2021. doi: 10.12201/bmr.202105.00013

  毛艾琳, 单越剑. 数字经济下青年灵活就业人员医疗保险参保契合度研究. 2023. doi: 10.12201/bmr.202304.00004

  余芷晴, 曾益. 上海市职工基本医疗保险基金可持续性评估及降费空间研究. 2022. doi: 10.12201/bmr.202210.00017

  姚强, 陈阿敏. 医疗保险参保地对老年流动人口健康状况的影响路径研究 ——基于2015年全国流动人口动态监测调查数据. 2022. doi: 10.12201/bmr.202111.00023

• 序号	提交日期	编号	操作
  1	2024-07-12	bmr.202411.00011V1	下载

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