不利选择是中国实现全民医疗保险覆盖面的障碍
Panxu Yang1, Siqi Zhong2, Xiangping Wang1
1School of Public Management, East China Normal University, Shanghai, People's Republic of China.
Risk management and healthcare policy
|March 12, 2025
概括
在中国的公共医疗保险 (PHI) 中,不利选择是显而易见的,高风险的个人更有可能注册. 这种行为在年轻,更健康的人群中更强烈,影响了普遍覆盖目标.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 保险市场动态 保险市场动态
背景情况:
- 负面选择对全民健康覆盖面构成重大威胁.
- 中国的公共医疗保险 (PHI) 面临着招生人数的下降,这与不利选择理论相一致.
- 了解不利选择对于PHI的可持续性至关重要.
研究的目的:
- 调查中国公共医疗保险市场中不利选择的存在和特征.
- 根据健康风险分析影响入学决策的因素.
- 探索推动PHI不利选择的机制.
主要方法:
- 利用了2020年中国家庭小组研究 (CFPS) 的数据.
- 采用Logit模型来评估住院和PHI招生之间的联系.
- 应用了多变试验模型来解决潜在的道德风险问题.
主要成果:
- 在健康风险 (住院) 和PHI招生之间存在显著的正相关性.
- 负面选择在年轻人和那些自我评估健康状况更好的人中更为明显.
- 个人利用过去的健康风险信息进行入学决策,表明战略行为.
结论:
- 无限制地注册PHI可以加剧不良选择.
- 风险调整保费和长期福利设计是减轻不利选择的潜在策略.
- 解决不利选择问题是确保中国PHI系统稳定和有效性的关键.
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