Shen Yupeng, Meng Yiming, Shan Yiyue, Zhang Shichen, Tang Daorui, Sun Zhengxiu
School of Insurance, Shandong University of Finance and Economics, Jinan, China.
School of Economics and Management, Southeast University, Nanjing, China.
Front Public Health. 2024 Nov 20;12:1467256. doi: 10.3389/fpubh.2024.1467256. eCollection 2024.
Using four waves of panel data from the China Labor-force Dynamic Survey (CLDS) spanning from 2012 to 2018, regarding gradual reforms of the Integrated Medical Insurance Scheme (IMIS) in China as a quasi-experiment, we establish a time-varying difference-in-differences (DID) model to systematically examine the impact of IMIS on the happiness of returning migrant workers. Further, a structural equation model is employed to explore the potential mechanisms and analyze the heterogeneity of the effect. The results indicate that IMIS significantly enhances the happiness of returning migrant workers, which remains robust after a series of robustness checks. In addition, this effect operates through two potential mechanisms, economic effects and integration effects, which account for 25.59 and 29.31% of the total effect, respectively. Compared to the older generation, low-income, low-health human capital, and high-reimbursement level regions, the enhancement of happiness due to IMIS is more pronounced among the new generation, high-income, high-health human capital, and low-reimbursement level regions of returning migrant worker, which might exhibit a "pro-wealth" characteristic. The findings provide empirical support and policy implications for continuously improving the health insurance system, promoting the equalization of basic public services between urban and rural areas, and consistently enhancing the happiness of returning migrant workers.
利用2012年至2018年中国劳动力动态调查(CLDS)的四轮面板数据,将中国城乡居民基本医疗保险制度(IMIS)的渐进式改革视为一项准实验,我们建立了一个时变差分(DID)模型,以系统地考察IMIS对返乡农民工幸福感的影响。此外,我们还采用了结构方程模型来探究潜在机制并分析效应的异质性。结果表明,IMIS显著提高了返乡农民工的幸福感,在一系列稳健性检验后,该结果依然稳健。此外,这种效应通过经济效应和融入效应这两种潜在机制发挥作用,分别占总效应的25.59%和29.31%。与老一代、低收入、低健康人力资本和高报销水平地区相比,IMIS对幸福感的提升在新一代、高收入、高健康人力资本和低报销水平地区的返乡农民工中更为显著,这可能呈现出一种“亲财富”特征。研究结果为持续完善医疗保险制度、促进城乡基本公共服务均等化以及持续提升返乡农民工的幸福感提供了实证支持和政策启示。