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医疗保险与消费:来自新型农村合作医疗的证据
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TitleHealth insurance and consumption: Evidence from China’s New Cooperative Medical Scheme  
作者白重恩 李宏彬 吴斌珍  
AuthorBai Chongen, Li Hongbin and Wu Binzhen  
作者单位清华大学经济管理学院经济系 
OrganizationSchool of Economics and Management, Tsinghua University 
作者Emailwubzh@sem.tsinghua.edu.cn 
中文关键词预防性储蓄 医疗保险 消费 新型农村合作医疗 中国储蓄 
Key WordsPrecautionary savings; Health insurance; Consumption; New Cooperative Medical Scheme; Chinese savings 
内容提要预防性储蓄常常被看成是中国高储蓄的一个重要原因。新型农村合作医疗的引入为我们提供了一个较好的自然实验来估计预防性储蓄的大小。我们利用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,平均来说,保险对除医疗支出外的消费的刺激作用超过5个百分点。而且即便是对于那些当年没有医疗支出的家庭,保险对消费的正向作用仍然显著。与此同时,我们发现保险对消费的正向影响在那些收入较低或健康状况较差的家庭中更强,而且随保障水平的提高而增强。这些结果都与医疗保险减少了预防性储蓄的说法相一致。另外我们还发现,保险的效果会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,新农合对那些新加入者的消费的影响明显小于对参合一年以上村民的消费的影响。 
AbstractWe 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 health insurance coverage increases non-healthcare related consumption by more than 5 percent. This insurance effect exists even for households with no out-of-pocket 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 all 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 at least 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.  
文章编号WP180 
登载时间2012-01-05 
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