中国医疗保险制度改革中的公平性研究——以威海为例

本文评估了中国医疗保险改革中一种具有普遍意义的模式—威海模式的公平性。首先 ,通过计算基尼系数、集中系数、Atkinson度量以及自定义的Iloss度量对卫生服务利用的不平等和筹资不平等进行总体描述。然后 ,通过多元回归分析 ,对影响卫生服务利用的因素进行分析。在此基础上 ,通过直接标准化方法 ,探讨收入所影响的卫生服务利用的不平等。最后 ,本文对筹资制度对再分配造成的冲击进行了分析。本研究发现 ,威海模式改善了收入影响的不平等 ,但其它因素影响变化各异。改革后筹资不平等有所改善 ,但筹资系统的再分配效应加大了收入不平等 ,改革前后这种效应的变化大小依赖于风险厌恶程度。

A Research on the Equity of the Reform of Chinese Health Insurance

This Paper assesses the equity of a general mode of the reform of Chinese health insurance-Weihai mode. Firstly it discusses the total inequality of access to the health system and the finance system of health insurance by calculating the Gini index, Atkinson index and Iloss which is proposed by the author. Then it studies the factors influencing the inequality by multi-factor regression. The effection of the finance system on the redistribution is also discussed. This paper finds that the Weihai mode improved the equity influenced by income, but the effection of other factors is different with each other. The equity of the financial system is improved after the reform, however the financial system enlarged the equality of income, and the change of the effection relied on the extent of risk aversion.