Research On The Impact Of Social Medical Insurance Participation On Family Intergenerational Transfer Payment

This article analyzes the impact of transfer payment recipients’ participation in social medical insurance on the upward and downward family intergenerational transfer payments.With the continuous deepening of the population aging in China,the "longevity era" is marked by low mortality,low birth rate,continuous increase in life expectancy,population structure from pyramid to columnar,and the plateaued elderly population exceeds 1/4.The advent of China’s social security system,especially the social medical security system,has put forward higher requirements.China’s current social medical system mainly includes basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance.However,due to disparity between urban and rural development,There are big differences in the reimbursement ratios and protection levels of the three basic medical insurances.Urban residents’ medical insurance,especially the new rural cooperative medical insurance,has a low degree of protection,and cannot fully cover the medical expenses incurred by the insured.In this case,the self-supporting proportion of medical expenses is borne by the intergenerational transfer payment between family members.How will the government-led short-term citizen mutual assistance form social medical insurance affect the long-term family mutual assistance form intergenerational transfer payment dominated by blood relationship?Realize the overall development of urban and rural social medical insurance,and form a comprehensive security system that promotes and complements each other between horizontal social medical insurance and vertical family intergenerational transfer payments.Firstly,This article summarizes the existing research on the motivation of family intergenerational transfer payment,and divides the motivation of family intergenerational transfer payment into two categories.One is altruism.This hypothesis is that the transfer payer provides family intergenerational transfer payment out of concern for the happy life of the transfer payment recipient,not in exchange for a certain service.Therefore,the poorer,sicker,or widowed transfer payment recipient is,the more intergenerational transfer payments can be obtained.The second is the motive of exchange reciprocity.This hypothesis believes that the reason why the transfer payer provides family intergenerational transfer payment to the transfer recipient is to obtain a certain service provided by the transfer recipient.According to the different services provided,the exchange reciprocity hypothesis can be divided into education Return on investment hypothesis,exchange service hypothesis,exchange legacy hypothesis and demonstration effect hypothesis.Secondly,this article refers to the existing research results and establishes a theoretical model of the impact of transfer payment recipients participating in social medical insurance on family intergenerational transfer payments.Under different directions of intergenerational transfer payments,Lagrangian functions are used by constructing effect functions.To maximize the utility of transfer payers,analyze the impact of transfer payment recipients’ participation in social medical insurance on intergenerational transfer payments between up and down families,and put forward two hypotheses based on the results of the theoretical model:Hypothesis 1:Elderly parents’participation in social medical insurance will "crowding-in" Intergenerational transfer payments in the upward family,the upward family intergenerational transfer payments provided by adult children to elderly parents mainly show the motivation of exchange reciprocity.Hypothesis 2:Adult children participating in social medical insurance will "crowding-out" the family intergenerational transfer payments,and the downward family intergenerational transfer payments provided by elderly parents to adult children mainly exhibit altruistic motives.Then it analyzes the mechanism of the impact of participating in social medical insurance on family intergenerational transfer payment,and proposes two ways of direct impact and indirect impact.The direct impact is mainly realized by reducing the medical expenses support of the insured,and the indirect impact is mainly through stimulating consumption and increasing Consumption level;reduce risk expectations and reduce preventive savings;improve health and increase human capital in three ways to achieve.Finally,this article uses CHARLS 2015 data to define the explanatory variables as upward family intergenerational transfer payments and downward family intergenerational transfer payments and the amount of corresponding transfer payments.The main explanatory variable is voluntary social medical insurance,including basic social medical care for urban residents.Insurance,new rural cooperative medical insurance,and social medical insurance for urban and rural residents.At the same time,the control variables of personal characteristics,economic characteristics,family characteristics,and regional characteristics are added to perform logit and Tobit regression of full sample data,Divide the sample data into three components according to age,economic income and region,and then perform the same regression separately.followed by the IV Probit instrumental variable method and the propensity score matching(PSM)to reduce the endogenous problems caused by the omitted variables and selection errors,and the robustness test was performed by transforming the data and replacing the regression method.Finally,the conclusions are drawn:①The participation of elderly parents in social medical insurance has a "crowding-in effect" on the intergenerational transfer payments of upward families,reflecting the motivation of exchange reciprocity;Hypothesis 1 has been verified;②The participation of adult children in social medical insurance affects the intergenerational transfer of downward families Payment has a"crowding-out effect",reflecting altruistic motivation;Hypothesis 2 has been verified.③Different ages,different economic income levels,and sample data in different regions,and the participation of transfer payment recipients in social medical insurance has different effects on the up and down family intergenerational transfer payments.Then use the intermediary effect test to conduct an empirical analysis on the mechanism of social medical insurance participation on family intergenerational transfer payments,and conclude that the impact of social medical insurance participation on family intergenerational transfer payments is mainly through direct effects,that is,reducing medical expenses to affect family intergenerational transfer payments.Among them,adult children’s participation in social medical insurance has a significant mediating effect on the consumption expenditure of the family’s intergenerational transfer payment mechanism,but it only accounts for 6.67%.In response to the above conclusions,the following four suggestions are put forward:explore the development of family-based insurance;broaden the scope and supply channels of social medical insurance;implement a differentiated social medical insurance system;control the growth of medical expenses reasonably.