Journal of Integrative Agriculture ›› 2021, Vol. 20 ›› Issue (4): 1068-1079.DOI: 10.1016/S2095-3119(20)63372-X

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  • 收稿日期:2020-02-20 出版日期:2021-04-01 发布日期:2021-03-28

The impact of the New Rural Cooperative Medical Scheme on the “health poverty alleviation” of rural households in China

QIN Li-jian1, Chien-ping CHEN2, LI Yu-heng3, SUN Yan-ming4, CHEN Hong   

  1. 1 Research Center for Health Economics, Anhui University of Finance and Economics, Bengbu 233000, P.R.China
    2 School of Business Administration, University of Houston-Victoria, Sugar Land 77449, USA
    3 Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, P.R.China
    4 Institute for Global Innovation and Development/Institute of Eco-Chongming/School of Urban and Regional Science, East China Normal University, Shanghai 200062, P.R.China
    5 School of Languages and Media, Anhui University of Finance and Economics, Bengbu 233000, P.R.China
  • Received:2020-02-20 Online:2021-04-01 Published:2021-03-28
  • Contact: Correspondence CHEN Hong, Tel: +86-552-3113120, E-mail: chenhong.china@163.com; LI Yu-heng, E-mail: liyuheng@igsnrr.ac.cn
  • About author:QIN Li-jian, E-mail: qinlj28@163.com;
  • Supported by:
    We gratefully acknowledge the supports by the National Social Science Fund of China (18FGL014), the Key Project of Humanities and Social Science Base of Anhui Province of China (SK2019A0491), the Humanities and Social Science Foundation of the Ministry of Education of China (18YJA790065), the Social Science Foundation of Anhui Province of China (AHSKY2017D01), the Outstanding Scholar Project of Anhui Province of China (gxbjZD12), the Key Project of the Social Science Foundation of Anhui Province of China (AHSKY2020D44), and the 2019 Major Project of the Social Science Foundation of Anhui Province of China (AHSKZD2019D04).

摘要:

基于全国性大规模的2016年度中国家庭追踪调查数据,使用工具变量法的IVProbit模型,本文实证研究了新型农村合作医疗保险对农村居民家庭健康脱贫的影响。研究发现,第一,新型农村合作医疗保险对农村居民家庭健康脱贫的效果显著。家庭成员患病进行住院治疗,增加了该家庭陷入贫困的风险,新型农村合作医疗保险显著降低了中国农村居民家庭陷入贫困的概率。第二,新农合对农村家庭健康脱贫的影响在不同收入人群之间存在显著的差别。新农合对中高收入组和高收入组农村家庭的健康脱贫没有影响,但是显著提高了低收入组、尤其中低收入组的农村家庭,其因病致贫和因病返贫的防范能力。第三,新农合对农村家庭健康脱贫的影响效果存在显著的地区差异。新农合显著降低了西部地区农村居民家庭陷入贫困的风险,对东部和中部地区的农村居民家庭没有影响。为了减少和消除贫困,增强农村居民的收入获取能力,本文建议采取以下措施:切实提高新型农村合作医疗保险的实际补偿比、积极推进新农合的支付方式改革以控制医疗费用增长、加强西部地区的医疗卫生服务综合体系建设、加强边缘贫困人口医疗保障的制度建设,以及加强农村地区的人居健康环境改造。


Abstract:

This study investigates the impact of the New Rural Cooperative Medical Scheme (NRCMS) on rural households to escape poverty.  We employ the instrumental variable method, the IVProbit model, to analyze the national data from the rural-resident field survey by the China Family Panel Studies (CFPS) in 2016.  Based on the large-scale data, we found that, first, the hospitalization of family members is the key factor in increasing the risk of the family falling into poverty.  The NRCMS has significantly reduced the likely risk of falling into poverty.  Second, the impact of the NRCMS on poverty alleviation varies among groups with different levels of income.  There is no impact on the upper-middle and high-income groups; in contrast, the NRCMS has substantially improved the capacity of low-income rural families to prevent poverty due to illness, especially for the lower-middle-income group.  Third, there exist significant regional differences in the impact of NRCMS on the health poverty alleviation of rural households in China.  The NRCMS has successfully reduced the risk of rural households in the western region falling into poverty, simultaneously, no significant impact on those in the eastern and central regions.  In order to diminish and eliminate poverty eventually and boost rural residents’ capacity for income acquisition, we propose the following: raise the actual compensation ratio of the NRCMS, control the rising expense of NRCMS by promoting the payment method reform, construct the comprehensive healthcare system in the western region, strengthen the medical security for the poor in remote area, and enhance the living environment for rural residents. 

Key words: New Rural Cooperative Medical Scheme ,  rural households ,  health poverty alleviation