补充医疗保险对居民消费的影响——来自城乡居民大病保险的证据

促进消费对我国稳定经济增长和构建新发展格局至关重要。本文基于中国家庭追踪调查数据(CFPS),利用地级市层面实施城乡居民大病保险的时间差异,运用双重差分法估计了大病医疗保险对居民消费的影响。结果表明,大病保险使家庭人均消费显著增长了约6%。使用了事件分析法、置换检验、改变回归样本和控制变量等一系列检验后,结论仍保持一致,且这一效果在期初住院率高、储蓄率高以及收入较高的家庭中更明显。进一步地,本文检验了大病保险对居民消费的三种可能影响渠道,发现降低家庭对未来医疗支出风险的预期是大病保险促进家庭非医疗消费进而影响家庭总消费的主要渠道,印证了我国居民对高额医疗支出的担忧是影响消费意愿的重要因素。本文研究对于完善多层次医疗保障体系和促进居民消费具有启示意义。     

Notes on some present day Questions regarding Mortality

Abstract

In the absence of any definite development of actuarial science in Great Britain which would be a suitable subject for this paper I considered that the most useful course would be to discuss some of the problems which are at present exercising my own mind, and no doubt the minds of many of my colleagues. Probably, many of these questions are akin to others which arise in other countries, so that their discussion at a meeting such as this may prove of mutual interest, while even if they are peculiar to ourselves, a disclosure of our doubts and difficulties will indicate the directions in which future developments may be expected. I must, however, emphasize that any views expressed are purely personal, and do not in any way pretend to represent a consensus of British actuarial opinion. Throughout this paper only Ordinary (as opposed to Industrial) business in considered.     

The genetics of breast and ovarian cancer V: application to income protection insurance

In Part IV we presented a comprehensive model of a life history of a woman at risk of breast cancer (BC), in which relevant events such as diagnosis, treatment, recovery and recurrence were represented explicitly, and corresponding transition intensities were estimated. In this part, we study some applications to income protection insurance (IPI) business. We calculate premiums based either on genetic test results or more practically on a family history of BC. We then extend the model into an IPI market model by incorporating rates of insurance-buying behaviour, in order to estimate the possible costs of adverse selection, in terms of increased premiums, under various moratoria on the use of genetic information.     

大病保险制度对农村中老年人医疗费用负担的影响研究

基于中国健康与养老追踪调查在2011、2013、2015和2018年的四期面板数据,本文利用地级市层面实施大病保险的时间差异,采用双重差分法实证分析大病保险制度对农村中老年居民医疗费用负担的影响,并从不同年龄层和收入两个角度对制度的实施效应进行异质性分析。研究发现：大病保险使农村中老年人的住院自付费用有效降低14.4个百分点,有助于医疗费用负担的减轻;大病保险的实施对中年人群体和中等收入群体的效果尤为显著,但对老年人群体、低收入群体和高收入群体的影响有限。据此,未来需要进一步完善制度设计,减少弱势群体的医疗费用负担。