医疗保险与消费:来自新型农村合作医疗的证据

本文利用农村引入新型农村合作医疗这一政策变化来研究医疗保险的获得对农村居民消费的影响。结果表明,新农合使得非医疗支出类的家庭消费增加了约5.6个百分点。这一正向作用随医疗保险保障水平的提高而增强,而且在没有医疗支出的家庭中仍然存在。同时,新农合对消费的正向影响在收入较低或健康状况较差的家庭中更强。这些结果都与医疗保险减少了预防性储蓄的假说相一致。另外本文发现,新农合的效果随农户在这个项目中的经历而变化。实际上只有在那些有村民获得保险补偿的村子,保险对消费的正向影响才显著,而且在这些村子中,新农合对新加入农户的消费的影响明显小于对参合一年以上农户的消费的影响。

Health Insurance and Consumption:Evidence from China’s New Cooperative Medical Scheme

We exploit a quasi-natural experiment arising from the introduction of a health insurance program in rural China, to examine how the insurance coverage affects household consumption. The results show that on average, the insurance coverage increases non-healthcare consumption by more than 5 percent. This insurance effect exists even for households with medical spending. In addition, the insurance effect is stronger for poorer households and households with worse self-reported health status. It also gets stronger when the insurance for households’ expenditure at the county-level hospitals gets more generous. These results are consistent with the precautionary savings argument. We also find that the insurance effect varies by household experience with the program. Particularly, the effect is significant only in villages where some households in the village have actually obtained reimbursement from the insurance program. Within these villages, the program stimulates less consumption among the new participants than among households that have participated in the program for more than one year.