Research On The Redistribution Effect Of Basic Medical Insurance Income Of Rural Residents

As one of the contents of the social security system,medical insurance is an important measure to regulate income distribution and narrow the income gap.To achieve the goal,a medical insurance fund is established by raising medical insurance premiums and financial subsidy funds,which is used to compensate the medical expenses incurred by the insured residents.In many existing literatures,the New Rural Cooperative Medical Insurance plays a positive role in the redistribution of rural residents’ income.But it may also cause the situation that the rich will get more benefits in the vertical direction.The basic medical insurance for urban and rural residents is unified in the system,aimed at improving the problems of urban-rural inequality and the lack of fairness in benefits for all classes in the redistribution of income of the New Rural Cooperative Medical Insurance and the urban residents’ medical insurance.This paper is aimed to explore the changes in the income redistribution effect and the system optimization effect of the rural residents ’ basic medical insurance system after urban-rural integration,as well as the income redistribution effect of the basic medical insurance for rural residents on residents of different income levels and different economic regions in the repayment process.Based on combing the relevant literatures on the basic medical insurance for rural residents and income distribution,this paper uses data from the 2016 and 2018 China Family Tracking Survey to make an empirical analysis of the total income redistribution effect of the rural residents’ basic medical insurance in reimbursement,the vertical redistribution effect of the rural residents’ basic medical insurance on different income groups,and its horizontal income redistribution effect between regions respectively by using Lorentz curve with Gini coefficient,MT index and Theil index.In result,it is found that the basic medical insurance system for rural residents has a positive income redistribution effect after the unification of urban and rural areas.On the one hand,it has a redistribution effect on different income groups in the vertical direction.On the other hand,though there is no obvious effect on improving income inequality between regions,there do exist a redistribution effect within regions.So that the basic medical insurance for rural residents needs to be further increased in favor of vulnerable groups.Based on the analysis of the development status,it can be found that the basic medical insurance for rural residents has the following problems.Firstly,the range of repayment is narrow and the amount of compensation is limited.Secondly,it lacks preferential care for key populations in terms of treatment setting.Thirdly,the level of financing is low and the resource allocation is unreasonable.In order to improve the basic medical insurance system,improve the income redistribution effect of the rural residents’ basic medical insurance,keep rural residents’ income stable,improve the ability of rural residents to resist disease risks,and promote social equity,this paper proposes policy recommendations from four aspects,based on the shortcomings of the basic medical insurance for rural residents.Firstly,the scope of medical insurance reimbursement should be expanded and the amount of reimbursement should be increased;secondly,the treatment and payment plan should be improved to focus the expenditure on the vulnerable groups;thirdly,the financing method and payment model should be improved;finally,the medical resources should be allocated rationally as well as the graded diagnosis and treatment mechanism should be improved.This paper is divided into six chapters,which are introduction,concept definition and theoretical basis,system evolution and operation status of the rural residents’ basic medical insurance,research design,the shortcomings of the income redistribution effect and the suggestions.Chapter 1 first clarifies the research background and significance,and then combs the relevant literatures from the three aspects of social security fairness,medical insurance fairness and income redistribution effect of the rural residents’ medical insurance,followed by the introduction of the research contents and methods.Chapter 2 reviews the welfare economics theory,fairness theory and anti-poverty theory,and introduces the related concepts of the rural residents’ basic medical insurance and income distribution.Chapter 3 analyzes the deficiencies of the basic medical insurance for rural residents in income distribution on the basis of reviewing the evolution and operation status of the basic medical insurance for rural residents.Chapter 4 first briefly introduces the models,methods and data,and then analyzes the mechanism of income redistribution of the basic medical insurance for rural residents.In addition,an empirical analysis of the overall income redistribution effect,vertical income redistribution effect and horizontal income redistribution effect is made to measure the contribution of the rural residents’ basic medical insurance to narrow the income gap.Chapter 5 analyzes the shortcomings of the rural residents’ basic medical insurance in regulating income distribution,and analyze the causes from the four levels,which are reimbursement,treatment,financing,and resource allocation,combined with the development status of the policy and the national conditions.Chapter 6 takes into account the shortcomings of the rural residents’ basic medical insurance in regulating income distribution,and puts forward suggestions on increasing the reimbursement compensation,optimizing the treatment and payment plan,adjusting the financing model,and allocating medical resources rationally.