Research On The Impact Of Integration Of Medical Insurance For Urban And Rural Residents On Health Care Expenditure

The integration of medical insurance for urban and rural residents is an important step in China.New rural cooperative medical insurance,medical insurance for urban residents and medical insurance for urban workers have been coexisting for a long time.The internal separation between urban and rural areas,system separation and management division have led to many problems,such as different medical burden for urban and rural residents,difficulty for floating population to seek medical treatment in other places,repeated insurance for personnel and financial subsidies.Therefore,"integration" is considered as an important measure to reduce the fragmentation of medical insurance system,reduce the medical burden of rural residents,and realize the fair medical insurance.At present,China is speeding up the completion of the integration,and all regions have issued time plans.Then,from the perspective of residents’ health care expenditure(regarded as residents’ medical expenditure at their own expense),what is the effect of integration policy after many years?Can the integration really reduce rural residents’ health care expenditure as a whole?Based on the above situation and thinking,this paper takes the macro panel data of 31 provinces in China from 2008 to 2018 as the research sample,based on the urban and rural and regional dimensions,studies the impact of urban and rural residents’health insurance integration on health care expenditure.After the data passes the parallel trend test,the multi period DID method is used for empirical research,and the PSM method is used to complete the robustness test.The results show that:the impact of integration policy on health care expenditure is different between urban and rural areas.With the implementation of the integration policy,the health care expenditure of rural residents decreased by 6.67%,and there was no significant impact on urban residents.And for rural residents,there are regional differences.The implementation effect of the integration policy is good in the eastern region,which reduces the residents’ health care expenditure by 10.56%,but has no obvious effect in the central and western regions.This shows that,on the whole,the integration has achieved good results,which has a significant effect on improving the health care treatment of rural residents,reducing the medical expenditure at their own expense and promoting the fairness between urban and rural areas.However,we should also see that there is still a long way to go to truly realize the equity of urban and rural medical insurance.The integration policy still needs to be implemented in the rural areas of central and Western China,and the integration of medical insurance at this stage still shows some problems,such as the overall low level of overall planning,the pressure of medical insurance fund balance and so on.