收入不平等和中国经常账户失衡问题研究

文章通过理论分析和实证分析论证了收入不平等和中国经常账户失衡的数量关 系.首先构建了收入不平等和经常账户关系的两期模型,研究表明:低收入人群的跨期消费决策受到参照群体(高消费群体)消费外部性的影响,且这种影响随着收入不平等程度的增加而增加;同时,收入不平等对经常账户的影响与金融发展程度相关.随着收入不平等程度的增加,金融发展程度越高,经常账户越容易产生赤字;当金融发展程度较低时,低收入人群获得自由借贷的范围和水平受到限制,普遍推迟当前消费,进而导致经常账户盈余.文章还基于中国1980-2012年的统计数据,采用GMM估计方法对收入不平等和经常账户的关系进行了实证研究,结果表明:收入不平等是造成中国经常账户失衡的重要影响因素;收入不平等对中国经常账户的影响还受制于中国的金融发展水平.     

医疗保险与城乡反贫困:1989-2006

文章利用中国健康与营养调查(CHNS)数据,估计了1989-2006年医疗保险对中国城乡家庭的反贫困效应。结果发现:发生灾难性卫生支出的城乡家庭比例较高,最穷的群体其医疗费用超过收入的比例增加,医疗保险对减少收入不平等只起到微弱作用。TIP贫困曲线表明,近几年,医疗保险补偿后,城乡患病家庭的贫困并没有减轻,医疗保险在减少贫困上的作用很小。分析贫困特征的多元回归模型显示,家庭成员数量、教育程度、抚养比率、参保人数等都影响了贫困,而条件多元回归模型则显示,医疗保险对贫困的变动没有影响。     

医疗保险与城市反贫困：1989-2006

文章利用中国健康与营养调查（CHNS）数据,估计了1989—2006年医疗保险对中国城乡家庭的反贫困效应。结果发现：发生灾难性卫生支出的城乡家庭比例较高,最穷的群体其医疗费用超过收入的比例增加,医疗保险对减少收入不平等只起到微弱作用。TIP贫困曲线表明,近几年,医疗保险补偿后,城乡患病家庭的贫困并没有减轻,医疗保险在减少贫困上的作用很小。分析贫困特征的多元回归模型显示,家庭成员数量、教育程度、抚养比率、参保人数等都影响了贫困,而条件多元回归模型则显示,医疗保险对贫困的变动没有影响。     

农村家庭灾难性卫生支出界定标准探讨——以河北省迁西县为例

为了探讨我国农村灾难性卫生支出界定标准,文章以2015年河北省迁西县参加新型农村合作医疗的家庭健康询问调查资料为基础,应用受试者工作特征(receiver operating characteristic curve,ROC)曲线和约登指数,探讨其作为河北省农村灾难性卫生支出界定标准的可行性,以期对未来河北省精准健康扶贫工作有所裨益。     

大病医保与家庭灾难性医疗支出

近年来,国家加快完善城乡居民医疗保险制度,着力实施大病医保政策,从而抑制家庭灾难性医疗支出的发生,并促进城乡居民医疗更加公平。而大病医保政策能否有效防止出现家庭灾难性医疗支出,是一个值得探讨的问题。文章从大病医保政策制定的具体内容出发,考虑到家庭灾难性支出的主要影响因素,分析了大病医保政策存在的局限性,由此提出相应的政策建议。     

农村居民医疗支出差异及影响因素分析

运用家庭预算资料中的居民医疗支出数据,分析了我国农村居民医疗支出差异及影响因素.研究发现,1990年代以来我国农村居民医疗支出经历了持续的增长过程,而在完全自费医疗的情况下,我国农村居民医疗支出的不平等主要源于农村居民的地区收入差异及医疗服务价格的影响,低收入农民的医疗需求不足.因此,政府应更多地关注农村居民特别是贫困地区农民的医疗保障,控制医疗服务价格.     

财政支出结构与农村贫困

本文利用1980年至2010年历年的各项国家财政支出数据,同时加入经济增长的因素,分析影响农村贫困减少的各因素及其作用。实证分析发现,政府卫生支出、GDP以及农村居民家庭人均纯收入的持续增长对农村减贫有积极的作用,而基本建设支出与教育经费支出等因素对农村贫困率的变化没有显著影响。     

人口结构变化对消费结构及储蓄率的影响分析

利用1995年、2002年和2007年的CHIPS(China Household Income Projects)数据实证分析了家庭人口结构变化对城乡居民家庭消费结构和储蓄率的影响。家庭收入、规模大小、户主年龄和家庭不同年龄人口占比等家庭人口结构变量对消费结构和储蓄率都有一定的影响。就消费结构来说,如教育支出方面,老年家庭明显低于年轻家庭;医疗保障支出方面,老年家庭明显高于年轻家庭。同时,研究表明我国城镇和农村家庭的户主年龄与储蓄率略呈U型结构,也就是说我国家庭微观储蓄率与经典的生命周期假设不一致。进一步探讨了未来家庭人口结构变化对中国家庭储蓄率和经济结构的影响以及相关政策涵义。     

健康风险与城镇居民家庭消费

利用2009年"中国城镇居民经济状况与心态调查"数据,本文首次实证研究健康状况主观感受蕴含的健康风险信息对家庭消费的影响,同时探讨医疗保险的健康风险缓解和消费促进效应。发现的主要结论如下:户主自身的健康状况感受通常对家庭甚至低收入家庭的消费都没有显著负影响,但老年户主的健康状况感受却是家庭重要的健康风险来源;健康风险对家庭消费的影响主要源于除户主外的健康感受差的成员和老年成员,健康风险大的家庭人均总消费、食品和非食品消费均更低,家庭会通过调整非食品消费来稳定食品消费以应对消费的健康风险效应;医疗保险有助于缓解家庭的健康风险,促进家庭消费,特别是对于低收入家庭而言。     

中国老年家庭的经济脆弱性与贫困

利用中国健康与营养调查(CHNS)2006和2009年的面板数据测度了老年家庭的经济脆弱性,检验各因素对经济脆弱性和贫困的相对影响力。老年家庭的经济脆弱性高于贫困;户主特征和家庭变量不同程度地影响到了经济脆弱性及贫困,代际间向上流动的私人转移支付对老年家庭的经济脆弱性和贫困没有作用;超过24%的非贫困家庭是经济脆弱性家庭;期望效用的脆弱性(VEU)方法表明,不平等虽然减少了脆弱性,但其影响经济脆弱性的力量最小,不可解释的风险是最重要的因素,异质性风险和协同性风险的力量居中。     

Insurance of Household Risks and the Rebalancing of the Chinese Economy: Health Insurance,Health Expenses and Household Savings

This paper studies the effects of a public insurance system, the New Cooperative Medical Scheme (NCMS) on household savings in rural China. We develop a theoretical model in which we explain the impact of health insurance on savings through the impact of health insurance on out‐of‐pocket (OOP) health expense given the household level of wealth and seriousness of illness. We test the model empirically using data from the China Health and Nutrition Survey. We run endogenous and exogenous quantile regressions to evaluate the effects of NCMS participation on the distributions of household savings and OOP health expense. The impact of NCMS varies with the seriousness of illness. The NCMS induces an increase in OOP health expense for mild illness and, inversely, a decrease in health payments for more serious illnesses. The NCMS also leads to a higher incidence of catastrophic healthcare spending. The impact of the NCMS, given a certain state of illness, also varies with the household level of wealth. Poor households face health expense for both mild and serious illnesses. As the NCMS has opposite effects on the OOP expense for these two kinds of illness, we observe no effect on poor households’ precautionary savings. Because the decrease in OOP health expense for mild illness is larger for less poor households, the NCMS induces a decrease in their savings. For the most affluent households, the higher decrease in OOP spending on most moderate illness is dominated by a sharp increase in catastrophic expense, causing an increase in savings. To significantly reduce household savings and enhance household consumption, the NCMS has to offer better coverage against both serious and catastrophic health risks.     

新型农村社会养老保险政策效果评估——收入、贫困、消费、主观福利和劳动供给

本文使用中国健康与养老追踪调查(CHARLS)数据,采用断点回归和双重差分识别策略,估计了"新农保"对农村老年人收入、贫困、消费、主观福利和劳动供给的影响。研究结果显示,"新农保"养老金收入显著提高了农村老年人的收入水平、减少了贫困的发生、提高了其主观福利,并在一定程度上促进了家庭消费和减少了老年人劳动供给。进一步的研究显示,健康状况较差的老年人受到的政策影响更大更显著,表明"新农保"的政策影响存在异质性。     

中国农村老人的劳动供给研究

本文利用2000年农户抽样调查数据,测算了中国农村50岁及以上人口的劳动参与率并分析了影响农村老年劳动力劳动供给的因素。研究发现,农村老人的劳动参与率较高;影响老人是否工作的因素主要是年龄、健康状况、所承担的责任、性别、居住方式和土地等家庭因素,与经济因素关系不大。分析结果表明,随着农村家庭的核心化和青壮年劳动力向城镇流迁,农村传统的家庭养老模式正面临冲击,必须在农村建立社会养老保障机制。     

中国农村家庭脆弱性的测量与分解

在理论层面上,本文在效用理论基础上对脆弱性进行了定义并对其分解以反映消费的不平等性和波动性。在实证分析层面上,本文使用CFPS(Chinese Family Panel Studies)数据对中国农村家庭脆弱性进行量化与分解。量化结果表明多数农村家庭是脆弱的;分解结果发现相对于村间不平等,村内不平等是脆弱性的主要组成部分。家庭脆弱性及五个分解部分对家庭特征集合变量的OLS回归结果表明:增加农村家庭收入是降低其脆弱性最有效的手段;提高劳动力平均受教育水平能够有效降低家庭脆弱性,但大学教育支出会显著提高家庭的脆弱性水平,这较好地解释了目前出现的农村籍高中生弃考大学这一现象;新型农村合作医疗和社会保险能有效降低农村家庭脆弱性;社会资本、更大的家庭规模和更高的劳动力占比有利于降低家庭脆弱性,这能较好地解释中国农村家庭频繁的送礼活动以及倾向于组建大家庭的现象。     

New cooperative medical scheme and medical expenditure in rural China

The New Cooperative Medical Scheme (NCMS) was launched in rural China in 2003, aiming to safeguard rural households against catastrophic medical expenditure. The implementation of the programme has been surrounded by the concern for the potential uncontrollable growth in medical expenditure due to moral hazard. Direct evidence on the relationship between the NCMS and total medical expenditure is still scant. Using a panel data set, the Rural Fixed‐point Survey (RFPS) 2003–2006 and a supplementary NCMS survey conducted in 2007, we find that joining the NCMS does not affect household medical expenditure.     

The determinants of access to health care and medicines in India

This article explores the issue of demand for health care and medicines in India where household share of total health expenditure is one of the highest among high- and low-income countries. Previous work found that important determinants include health status, socio-demographics, income and demand for care was inelastic. Compared with previous studies, this article uses large household data sets including data on medicine expenditure to explore health-seeking behaviour. Count models find that determinants include health status, socio-demographic information, health insurance, household expenditure and government regulation. Elasticities range from ?0.13 to 0.03 and are generally consistent with literature findings. For inpatient care, conditional on having at least one hospitalization, the expected number of hospitalizations increases with being male and household expenditure. Medicine expenditure accounts for a large share of household health expenditure. Low-income individuals could experience problems and raises important policy implications on the demand and supply side to improve access to health care and medicines for patients in India.     

营养、健康与效率——来自中国贫困农村的证据

运用来自中国贫困农村的数据 ,本文系统地研究了营养、健康对劳动生产率或者说收入的影响。在控制着营养和健康变量“内生性”的前提下 ,本文估计了不同的营养和健康指标在中国贫困农村的回报和弹性。结果表明 ,几乎所有的营养和健康方面都影响到农村的劳动生产率 ,其中 ,营养摄入和疾病的影响最为显著。平均来看 ,卡路里拥有量每增加 1 % ,种植业收入会相应增加 0 57% ;而家庭劳动力因病无法工作时间每增加一个月 ,种植业收入将减少 2 3 0 0元。这些结果说明 ,要想使农民摆脱贫困的束缚 ,投资于营养和健康具有至关重要的作用。     

LIVING STANDARDS INEQUALITY BETWEEN MIGRANTS AND LOCAL RESIDENTS IN URBAN CHINA—A QUANTILE DECOMPOSITION

This study investigates the inequality in per‐capita consumption expenditure between urban and rural‐to‐urban migrant households in China using Rural‐Urban Migration in China (RUMiC) data. The methodology used is that of Oaxaca‐Blinder and unconditional quantile decompositions and we deal with selection related to education level using matching. It is found that the characteristics effect does not contribute toward explaining any of the gaps in consumption. Results from a detailed decomposition suggest that differences in educational level account for 8%–19% of the overall inequality after taking selectivity of education into consideration. Differences in household size and region of residence are also important in narrowing expenditure inequality between the two groups. (JEL R23, C15)     

Out-of-pocket health care expenditure in Turkey: Analysis of the 2003–2008 Household Budget Surveys

This paper analyses the prevalence of ‘catastrophic’ out-of-pocket health expenditure in Turkey and identifies the factors which are associated with its risk using the Turkish Household Budget Surveys from 2003 to 2008. A sample selection approach based on Sartori (2003) is adopted to allow for the potential selection problem which may arise if poor households choose not to seek health care due to concerns regarding its affordability. The results suggest that poor households are less likely to seek health care as compared to non-poor households and that a negative relationship between poverty and experiencing catastrophic health expenditure remains even after allowing for such selection bias. Our findings, which may assist policy-makers concerned with health care system reforms, also highlight factors such as insurance coverage, which may protect households from the risk of incurring catastrophic health expenditure.