Research Center for Health Economics, Anhui University of Finance and Economics, #962 Caoshan Road, Bengbu City, Anhui Province, 233000, China.
School of Business Administration, University of Houston, Victoria, 77449, USA.
Soc Sci Med. 2021 Mar;272:113700. doi: 10.1016/j.socscimed.2021.113700. Epub 2021 Jan 14.
The study explores the impacts of health insurance on the social integration of both rural migrants and urban migrants into cities in China. We construct a comprehensive integration index and employ the Quantile Regression method to examine the data collected from a nationwide survey by China's National Health Commission. We found that first, the degree of social integration of rural-urban migrants into cities is weaker than that for urban-urban migrants in varied dimensions. The gap between the two types of migrants' integration increases from lower quantiles to higher quantiles. Second, health insurance provided by the destination cities has improved the integration for both types of migrants. Its positive impact on social integration also accelerates in quantiles. Third, the accelerating positive impacts of health insurance on the rural-urban migrants' integration in quantiles are more significant than those for the urban-urban migrants. On the policy front, it is therefore important to raise the insurance participation rates, especially for the rural-urban migrants, to facilitate their social integration into cities for a more productive and stable labor force. For the migrants' smooth integration to achieve the high-quality urbanization, we also propose to deliver more affordable medical services through the competition by more private sector healthcare providers. Then a mandatory health insurance policy for all migrant employees, compensated substantially by employers, should be implemented to expand the coverage. Finally, a cross-region transfer of health insurance is also suggested to maintain the improving participation, especially for the low-income migrants.
本研究探讨了医疗保险对中国农村移民和城市移民融入城市的社会融合的影响。我们构建了一个综合的融合指数，并采用分位数回归方法，检验了中国国家卫生健康委员会全国调查收集的数据。我们发现，首先，城乡移民融入城市的社会融合程度在各个维度上都弱于城市内部移民。这两种移民融合程度的差距从较低的分位数到较高的分位数都在扩大。其次，目的地城市提供的医疗保险提高了两种类型移民的融合度。其对社会融合的积极影响在分位数上也在加速。第三，医疗保险对农村移民融合的分位数的加速积极影响比城市内部移民更显著。因此，在政策层面上，提高保险参与率很重要，特别是对农村移民来说，以促进他们更顺利地融入城市，成为更有生产力和更稳定的劳动力。为了实现高质量的城市化，使移民能够顺利融合，我们还建议通过更多私营部门医疗服务提供商的竞争来提供更负担得起的医疗服务。然后，应该实施一项强制性的医疗保险政策，由雇主全额补偿，以扩大覆盖面。最后，还建议实行医疗保险跨地区转移，以保持参与率的提高，特别是对低收入移民。
