An Empirical Study On Moral Hazard Of Social Medical Insurance For The Middle Aged And Elderly People In Rural Areas

With the continuous development of social economy,the proportion of the elderly population continues to increase.In the process of aging society,the health status of the middle-aged and elderly population is increasingly worthy of attention.Especially for rural middle-aged and elderly people,the phenomenon of "empty nests" is increasing due to reasons such as their children going out to work and get married.Under my country’s current basic medical insurance system,medical insurance has already covered a wide range and is developing in a high-quality direction,which has effectively improved the health of Chinese residents.But medical expenditures have also increased.This article explores the impact of the new rural cooperative medical insurance system and urban and rural medical insurance on health behaviors and medical expenditures,which is of great significance for improving individual health behaviors and realizing the original intention of establishing basic medical insurance.This article first uses cross-sectional data from CHARLS in 2015 to analyze the impact of the new rural cooperative medical system on health behaviors and medical expenditures,and further examines the moral hazard afterwards by analyzing the relationship between medical expenditures and living expenditures.Secondly,through the screening of CHARLS data in 2015 and 2018,this paper constructs balanced panel data and analyzes the impact of urban and rural medical insurance on health behavior and medical expenditure.Finally,considering that there may be differences in the impact of different genders,the regression is carried out by gender,and the gender differences in the impact of the new rural cooperative medical system on health behavior and medical expenditures and the impact of urban and rural medical insurance on health behavior and medical expenditures are analyzed separately.Gender differences.The main research conclusions drawn in this paper are as follows: First,in the impact of the new rural cooperative medical system on health behavior and medical expenditure,evidence of the existence of pre-mortal hazard and post-mortal hazard has been found.The new rural cooperative medical system has a positive impact on drinking behavior and medical expenditure.And the medical expenditure did not crowd out the living expenditure,indicating that it is more likely to be a moral hazard after the fact rather than the release of normal medical needs.Second,in the impact of urban and rural medical insurance on health behavior and medical expenditures,evidence of moral hazard before the event was found,but no moral hazard after the event was found.The overall planning of urban and rural medical insurance has a positive effect on smoking and drinking behavior,and reduces the probability of physical activity.For medical expenditure,the overall planning of urban and rural medical insurance has no effect.Third,in the impact of the new rural cooperative medical system on health behaviors and medical expenditures,there are obvious differences between genders.Men are affected more and more significantly.The gender difference in the impact of urban and rural medical insurance on health behaviors and medical expenditures is slightly smaller.At the end of this article,on the basis of the summary,combined with the research conclusions,four policy recommendations are put forward:(1)Social medical insurance should cover preventive health care services to help residents increase their health awareness;(2)Introduce relevant mechanisms in the premium and reimbursement design of social medical insurance to avoid moral hazards after the fact;(3)Further strengthen medical information construction,Digitally record the behavior of doctors and patients to prevent prior moral hazards;(4)Continue to promote the reform of medical insurance payment methods to achieve more refined management of hospitals.