Research on the Economic and Social Effects of Medical Insurance System and Structure Optimization
|Keywords||medical insurance residents’ consumption health level structure optimization|
Medical insurance plays an important role in further reform of medicine andhealth system. Both on the long-term objective of medicine and health system reform,namely as four system establishment, and on the short-term objective, namely aspromoting the five reforms, medical insurance occupys an important position. In therecent ten years, the development of the national medical insurance system changedrapidly. By the end of2011, the number of people participating in basic medicalinsurance surpasses1.3billion, with the coverage of95percent. At the same time,the commercial medical insurance achieves good results. By the end of2011, thepremium income of commercial medical insurance accounts to69.17billion Yuan.From the perspective of economics, the development of the medical insurancereflects a positive and realistic significance for the transformation of the mode ofeconomic development and promotion of people’s livelihood. The economic andsocial benefits of medical insurance are at least embodied in the following twoaspects: on one hand, stabilizing the expected income of residents, releasingconsumption demands and motivating domestic demands by casting off the worries ofbeing into poverty because of illness; on the other hand, elevating national health,labor productivity and human capital of the residents. Therefore, the establishment ofmedical insurance system covering urban and rural is an effective means of realizingthe sustainable economic development. However, we can’t just develop a singlemodel of health insurance for information asymmetry and government failure, Wemust develop various forms of medical insurance, including basic medical insurance,commercial medical insurance and complementary medical insurance, etc. Theefficiency can be upgraded by the competition between different insurance modes,and it will remedy the defect to each other by cooperation to ensure the stabilizationof the whole medical insurance market between justice and efficiency.This paper is dedicated to the researches on economic and social benefits andoperational modes of medical insurance system. Firstly, we summarizes the effects of medical insurance on precautionary savings and health human capital from thetheoretical perspective,then we makes empirical analysis by using the regional paneldata and the survey data from the National Health Services Survey. Secondly, wemakes the comparative analysis of the typical international medical insurance system,explores concrete operational modes of medical insurance system of our country bytheoretical summary and practical experience of other countries and puts forwardfurther improvements by combining the characteristics of medical insurance systemof our country at current stage.This article is divided into seven chapters, besides the first chapter isintroduction, the other six chapters are as follows:The second part is the literature review. This paper introduces the literaturesfocusing on the following areas: the theory of the relationship between medicalinsurance and consumption, the theory of the relationship between medical insuranceand national health, the theory of the relationship between basic medical insuranceand commercial insurance. We introduce the theoretical and empirical thesis withgreat effects in these three fields worldwide.The third part is the international experience. We introduce the medicalinsurance system of the United States, Germany and United Kingdom, including thehistorical background, development processes, reform trends, the coverage of socialmedical insurance and commercial medical insurance, government financial support,personal or unit payment proportion, self-paying proportion, etc. of these countries.The fourth part is the empirical analysis of the effect of medical insurance onconsumption demand. After reviewing the development processes of national medicalinsurance system and resident consumption, we establish four modes including themodel of urban residents’ basic medical insurance, the model of new ruralcooperative medical insurance, the model of urban workers’ basic medical insuranceand the model of commercial medical insurance to analyze the effects of medicalinsurance on resident consumption. The data we used in these models is the paneldata of the31provinces, autonomous regions inhabited by minorities, andmunicipalities directly under the supervision of the central government in China. Theempirical results show that the medical insurance obviously stimulates resident consumption. However, the consumption stimulation of urban resident medicalinsurance is greater than that of new rural cooperative medical insurance and theconsumption stimulation of commercial medical insurance is greater than that ofurban workers’ basic medical insurance.The fifth part is the empirical analysis of the effect of medical insurance onnational health. After the retrospection of the development process of the nationalhealth condition and characteristics of current stage, we inspect the effect of basicmedical insurance on the national health level in China by using the data from theFourth National Health Services Survey. We found that the urban residents’ medicalinsurance has positive effects on national health.The sixth part is the discussion of the medical insurance operation mode. In theprocess of promoting medical insurance system, a considerable problem is needed tobe clear: the location of the relationship between commercial medical insurance andsocial medical insurance. From international experience, medical insurance systemsof many countries adopt “double-track system”. The difficult points of this system isthe role division arrangement of commercial medical insurance and social medicalinsurance, the nature of the problem is the power division of government and market.Based on economics of insurance and the experience at home and abroad, weexplores the rationality of the existence of “double-track system” in China and putsforward suggestions according to the current condition of our country.The seventh part is the policy proposal. Firstly, we summarize the views comingfrom the former researches. Then, we put forward some advices on the direction ofthe next stage of medical insurance reform, including confirming the focus ofdevelopment of basic medical insurance, rational division of commercial medicalinsurance and social medical insurance, etc.