残障人士就业影响因素实证研究

残障人士就业受到性别、年龄、文化程度、技能等多方面因素的影响。文章通过对来自江苏250个样本数据的逻辑回归发现,残障人士中男性比女性更容易就业,青壮年比中老年更容易就业,技能对残障人士就业的影响显著,同时不同因素对就业的影响是不同的。政府应在消除就业歧视的同时,注重对残障人士技能的培训,完善九年义务教育,提高残障人士的文化程度。     

医疗保险的福利效应

本文考察在完全信息的市场经济条件下,医疗保险的进入对于社会总福利的影响。分析表明,保险公司的进入可能使得消费者为医疗服务付出更高的代价,但是会提高医院的利润,总的来说保险公司的进入会提升社会总福利。本文还发现,由于保险公司未考虑其合约设计对医院利润的影响,市场均衡的医疗保险水平仍低于社会最优水平。这些结论有助于澄清相关文献对医疗保险的一些负面看法。     

郝演苏：警惕“地下保单回流”

当初，香港的保险公司通过各种方式在内地卖保险，“地下保单”在广东一带非常多。如今，香港人又通过各种关系来内地买保险，“地下保单”又在回流     

Impacts of publicly funded health insurance for adults on children's academic achievement

Publicly funded adult health insurance through the Affordable Care Act (ACA) has had positive effects on low-income adults. We examine whether the ACA's Medicaid expansions influenced child development and family functioning in low-income households. We use a difference-in-differences framework that exploits cross-state policy variation and focus on children in low-income families from a nationally representative, longitudinal sample followed from kindergarten to fifth grade. The ACA Medicaid expansions improved children's reading test scores by ~2% (0.04 SD). Potential mechanisms for these effects within families are more time spent reading at home, less parental help with homework, and eating dinner together. We find no effects for children's math test scores or socioemotional skill development.     

Perceived need and actual demand for health insurance among rural Chinese residents

One would expect that an individual perceives a need for health insurance before making a purchase. However, simply perceiving a need for insurance is not sufficient for making a purchase. When insurance is “lumpy” individuals perceiving a need may not make a purchase if financial resources are lacking. In this paper we develop a theoretical model which differentiates need from demand for health insurance. We then empirically investigate rural health insurance demand in China. We find that factors like children, education and wealth affect perceived need differently from the way they affect demand.     

The impact of diabetes insurance mandates on infant health

Among the factors thought to contribute to lagging improvements in infant health in recent years are increasing obesity and diabetes prevalence among women of childbearing age. This article uses a difference‐in‐difference‐in‐difference empirical strategy to investigate the impact of mandated insurance coverage for diabetes on adverse pregnancy outcomes. Among educated women, who have high rates of coverage through private insurance that is subject to insurance mandates, diabetes mandates are associated with a reduction in low birth weight and premature birth prevalence. These gains are concentrated among older women and are larger for African‐Americans. There is a weaker effect on the prevalence of high birth weight, potentially because of the deleterious effects of an increased probability of pregnancy weight gain in excess of 35 pounds among diabetic women in states with mandates.     

购买保险提防被忽悠安心投保学会五要诀

如何加强自警,提防保险方面的诈骗。在现实生活中,真正的保险诈骗事件还是少之又少。真正让许多投保者吃药．还是各类”保险忽悠”,买的时候说得花好稻好,最后才发现自己买的保险产品根本不是那么一回事。那么。买保险时如何提防”被忽悠”呢？以下几个要点相信会有所帮助。     

购买保险提防被忽悠 安心投保学会五要诀

如何加强自警,提防保险方面的诈骗。在现实生活中,真正的保险诈骗事件还是少之又少。真正让许多投保者吃药,还是各类保险忽悠,买的时候说得花好稻好,最后才发现自己买的保险产品根本不是那么一回事。那么,买保险时如何提防被忽悠呢?以下几个要点相信会有所帮助。     

Impact of urban-rural health insurance integration on health care: Evidence from rural China

In recent years, Chinese local governments have experimented with integrating the social health insurance system segmented between rural and urban areas to unify the administration, policy, and funds of various health insurance programs. In this study, we take advantage of the staggered implementation of the urban-rural health insurance integration across cities over time to examine the impacts of the integration on rural residents' health care utilization and health outcomes. Based on an original city-year level policy dataset and the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011, 2013, and 2015, we find that the integration significantly increases the middle-aged and older rural residents' inpatient care utilization and this positive effect is particularly salient in poor areas. Moreover, we find that the positive policy effect of integration is attributed to enhanced health insurance benefits, such as a higher reimbursement rate for inpatient care. However, the integration has limited impacts on the middle-aged and older rural residents' health outcomes. This study reveals the partial success of urban-rural health insurance integration to reduce health care inequality in China.     

Who bears the burden of social insurance? Evidence from Japanese health and long-term care insurance data

Using the society-managed health insurance data, which is cross-sectional time-series and covers 1670 health insurance societies for seven years (FY1995–2001), we found for the first time in Japan that the majority of the employers' contribution to health insurance is shifting back onto the employees in the form of wage reduction. On the other hand, we cannot find such evidence for the contribution to long-term care insurance using a two-year (FY2000–2001) panel data set. The difference can be theoretically explained by how employees value the contribution relative to social security benefits they enjoy. J. Japanese Int. Economies 18 (4) (2004) 565–581.     

General health conditions and medical insurance issues concerning black women

In the last 30 years the health status of black women has improved. However, the likelihood of health problems from complications of pregnancy and childbirth or prolonged illness from combined effects of diabetes, hypertension, and obesity remains. The need for continuity of care for these conditions and the low economic status of black women suggest that current policy shifts away from emphasis on increased access to medical care will adversely affect the health status of black women. Policies to contain health-care costs should therefore be designed to assure appropriate access to needed care for black women and other low-income groups.     

The effect of health insurance reform: Evidence from China

This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey¹ we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.     

Cross product subsidization in the health insurance market with managed care: A model and issues

One theory of insurance markets suggests that entering insurers expect incumbent insurers to react to the entry of new products, offering a combination of products where, breaking even, one makes positive economic profits and the other makes a loss. This theory is extended to include moral hazard, in which the magnitude of the loss depends on insurance coverage, and a stylized model of managed care. With moral hazard, cross-subsidization is still predicted. In contrast to prior results, the coverage for the highest risk individuals will vary with the portion of high-risk individuals in the market. The inclusion of managed care as a signaling instrument does not disrupt cross-product subsidization. These theoretical predictions are discussed in light of the absence of empirical support to date and in light of other factors that might limit or enhance an insurer's ability to subsidize across products.     

Analysis of hospital technical efficiency in China: Effect of health insurance reform

This paper investigates the regional hospital efficiency in China during the 2002–2008 period, especially for how the health insurance reform of New Rural Cooperative Medical System (NRCMS) impacts on efficiency. Adopting the non-parametric technique of data envelopment analysis (DEA) to handle the feature of multiple outputs and undesirable outputs in the hospital industry, empirical estimates indicate that hospital efficiency is moderate that increased slightly from 0.6777 to 0.8098 during the sample period. However, it ranges widely from 0.396 to 1 across provinces. The regression analysis on examining determinants of efficiency suggests that a higher proportion of for-profit hospital and high quality hospital is helpful to enhance technical efficiency. We find a negative relationship between government subsidy and efficiency for coastal regions. While technical efficiency varies considerable across provinces, there is no significant difference between coastal and non-coastal regions being found, after controlling for other variables. Crucially, the medical reform of NRCMS overall has a significant efficiency-enhancing effect, particularly for non-coastal regions, ceteris paribus. It highlights the effectiveness of NRCMS on promoting medical service accessibility for rural residents.     

Impact of supplementary private health insurance on hospitalization and physical examination in China

Private health insurance (PHI) is considered an important supplement to the basic social health insurance schemes in the Chinese healthcare system. However, whether the strategy of engaging PHI as supplementary coverage is effective cannot be determined without knowing the impact of supplementary PHI on healthcare access and utilization, the evidence on which is currently absent in China. Therefore, we aimed to investigate the effects of supplementary PHI on hospitalization and physical examination to provide such evidence in the Chinese setting. We conducted a cross-sectional analysis using data from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Using probit models and bivariate probit models with instrumental variables (IVs), we evaluated the effects of supplementary PHI on the utilization of hospitalization and physical examination. Our analyses provided evidence that supplementary PHI increased the probability of physical examination but decreased that of hospitalization.Our findings suggest that supplementary PHI in China may effectively promote the use of high-value preventive care, thereby reducing subsequent utilization of expensive medical services. The present study provided preliminary evidence that the China healthcare system can benefit from engaging PHI as supplements to SHI.     

美国医疗保险模式对我国医疗保险制度的启示

美国是世界上社会保障制度比较成熟的发达国家,其医疗、养老、失业、生育以及老年残障保险等方面均走在世界前列.关于医疗保险的形成与发展,应追溯到20世纪20年代.当时,美国受经济发展水平、政治制度和历史文化传统因素的影响,形成了以商业医疗保险为主体、公共医疗保险计划为补充的医疗保障体系,在这种制度背景下,它不但促进了美国社会保障事业的快速发展,也推动了整体国民素质的提升.     

Income-dependent impacts of health insurance on medical expenditures: Theory and evidence from China

Policymakers are interested in the impact of health insurance on individuals’ medical expenditures—not only the average effect for the overall population, but also the possible heterogeneous effects for subgroups. This paper focuses on the heterogeneous impacts of a nationwide health insurance program in China, the New Rural Cooperative Medical Scheme, on its enrollees’ out-of-pocket (OOP) expenditures for different income groups, since previous studies find no significant reduction in OOP for the general population. We firstly develop a theoretical model, showing that the reduction in OOP for the rich would be greater. Then, we test the theoretical prediction using a unique sample. The empirical finding is consistent with the model prediction, and the pattern of income-dependent impacts is robust to different estimation strategies.