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城乡居民基本医疗保险对中国社会公平感的影响。

The impacts of basic medical insurance for urban-rural residents on the perception of social equity in China.

作者信息

Wang Xin, Chen Xiangyu, Li Lele, Zhou Deshui

机构信息

School of Maritime Economics and Management, Dalian Maritime University, Dalian, China.

School of Labor and Human Resources, Renmin University of China, Beijing, China.

出版信息

Cost Eff Resour Alloc. 2024 Aug 3;22(1):57. doi: 10.1186/s12962-024-00565-w.

Abstract

BACKGROUND

Based on CSS 2019 data, this article analyzes the impact of Basic Medical Insurance for Urban and Rural Residents (BMIUR) on perceived social equity of residents.

METHOD

Using the CSS data of 2019, this article analyzes the influence of BMIUR on the perception of social equity of residents, on the basis of 2SLS model and mediating effect model.

RESULTS

We find that BMIUR has a significantly positive impact on the perception of social equity. That is to say, BMIUR can improve residents' evaluation of social equity and further promote the level of social equity, which makes residents more happiness. The conclusion remains valid after using robustness test and propensity score matching to conduct counterfactual reasoning. The discussion of mechanism indicates that the influence of BMIUR is mediated by enhancing social capital, improving satisfaction of income distribution and reducing self-paid medical expenses. This study also finds that the influence of BMIUR is more obvious in the low-income, low-skilled and mid-west groups.

CONCLUSION

The reform of the medical security system should be regarded as a foothold for improving people's well-being and promoting social equity; Expanding people's social capital through multiple channels and improving income distribution mechanisms; Strengthen vocational skills training, especially to provide more public services and social security for low-income groups, low-skilled groups, and groups in the western region of China, in order to improve the welfare and policy effectiveness of China's social security reform.

摘要

背景

基于2019年中国社会状况综合调查(CSS)数据,本文分析城乡居民基本医疗保险(BMIUR)对居民感知社会公平的影响。

方法

利用2019年CSS数据,在两阶段最小二乘法(2SLS)模型和中介效应模型的基础上,分析BMIUR对居民社会公平感知的影响。

结果

我们发现BMIUR对社会公平感知有显著的正向影响。也就是说,BMIUR可以提高居民对社会公平的评价,进而提升社会公平水平,使居民更加幸福。在使用稳健性检验和倾向得分匹配进行反事实推理后,该结论仍然成立。机制讨论表明,BMIUR的影响是通过增强社会资本、提高收入分配满意度和降低自付医疗费用来介导的。本研究还发现,BMIUR的影响在低收入、低技能和中西部群体中更为明显。

结论

医疗保障制度改革应立足改善民生、促进社会公平;通过多种渠道拓展民众社会资本,完善收入分配机制;加强职业技能培训,尤其要为低收入群体、低技能群体和中国西部地区群体提供更多公共服务和社会保障,以提高我国社会保障改革的福利水平和政策成效。

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