“新农合”参保行为的选择效应检验——基于多维不对称信息的视角
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| Title | Selection in the New Cooperative Medical Scheme——A Test with Multiple-Dimension Asymmetric Information
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| 作者 | 王冬妮 王国军 祝伟 |
| Author | Wang Dongni, Wang Guojun and Zhu Wei |
| 作者单位 | 对外经济贸易大学保险学院 |
| Organization | School of Insurance, University of International Business and Economic |
| 作者Email | asyz_isabel@126.com;gjwang2009@163.com;zhuwei@uibe.edu.cn |
| 中文关键词 | 逆向选择 道德风险 社会医疗保险 |
| Key Words | Adverse Selection; Moral Hazard; Social Medical Insurance |
| 内容提要 | 在自愿参保模式下，新型农村合作医疗（新农合）的参保行为不可避免地会受到不对称信息的影响，从而可能产生逆向（或正向）选择的现象，将对居民福利产生负面影响，因此这一选择效应的识别构成了新农合绩效评估研究的基础。已有的研究主要局限于由健康风险引起的选择行为并且由于实证设计的局限性未能提供选择行为存在与否的直接证据，本文基于经典的不对称信息实证分析框架从多维不对称信息的视角对已有研究进行了拓展，运用高质量的家庭微观调查数据，在区分新农合引发的道德风险影响的基础上系统地检验了新型农村合作医疗参保行为的选择效应，结果发现新农合在健康风险和认知能力等维度上不存在选择效应，但谨慎态度导致了逆向选择现象；新农合参保引起的医疗服务利用的增加主要是由于道德风险引起，其他维度不可观测的不对称信息并未导致显著的选择效应。 |
| Abstract | Given the voluntary nature of the participation in the New Cooperative Medical System (NCMS), the participation is inherently affected by private (and thus asymmetric) information owned by rural households. This asymmetric information might lead to adverse selection or advantageous selection, reducing the welfare of rural households. Therefore, the identification of the selection in the NCMS is necessary for welfare assessment of the NCMS. Instead of the previous focus on adverse selection caused by the private health risk information, we introduce other dimensions of asymmetric information and isolate the impact of moral hazard to test the potential selection by using a high-quality household survey data. Our results demonstrate that there exists no adverse selection in the dimensions of private information on health risk as well as cognition, yet cautiousness leads to the selection. We further show that it is moral hazard that increases the possibility of the NCMS participants going to hospital, while other unobservable information does not lead to the selection in the NCMS. |
| 文章编号 | WP1237 |
| 登载时间 | 2017-11-10 |
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