Study On The Impact Of Urban And Rural Medical Insurance Planning On The Long-term Migration Intention Of Agricultural Floating Population

On January 12,2016,the State Council issued the Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents,which fully launched the urban and rural medical insurance coordination work.Prior to this,China’s urban and rural basic medical insurance system showed a dichotomous pattern,with urban residents enjoying greater coverage and higher reimbursement ratios for urban residents’ basic medical insurance compared to the new rural cooperative medical insurance that rural residents are enrolled in.The fragmented basic medical insurance system not only aggravates the inequality of medical resources between urban and rural areas,but also brings problems such as cumbersome procedures for settlement of medical treatment in different places and difficulties in reimbursement to a large number of migrant agricultural population.The issue of agriculture and rural farmers is a fundamental issue related to the country’s livelihood,and urbanization is a necessary path to modernization and a powerful support for rural revitalization and coordinated regional development.The National Development and Reform Commission in the "Key Tasks of New Urbanization Construction in 2019" clearly requires accelerating the implementation of the new urbanization strategy with the promotion of human urbanization as the core,actively promoting the settlement of the agricultural transient population already employed in cities and towns,and achieving full coverage of basic public services.As the agricultural migrant population is the core force of China’s new type of urbanization,it is necessary to ensure that the migrant population can also enjoy fair social welfare and protection in the place of inflow,of which basic medical insurance protection is an important element.The introduction of the urban and rural medical insurance coordination system has simplified the procedures of medical treatment and settlement in different places for the migrant population and improved the basic medical insurance treatment for the agricultural migrant population.Can participation in the urban-rural health insurance system enhance the long-term migration intentions of agricultural migrants? Studying this question and clarifying the migration motives of agricultural migrants are of great practical significance to enhance the equity of urban and rural medical insurance and to promote the development of new urbanization and the implementation of rural revitalization strategy.Based on the above background,this thesis uses push-pull theory,dual economy theory,expected income theory,and new labor migration theory as the theoretical basis,and uses cross-sectional data from the National Mobility Dynamics Monitoring(CMDS)2017 to empirically test the impact of the urban-rural health insurance coordination system on the long-term migration intentions of agricultural migrants.The research content and structure of this thesis are arranged as follows: the first part is the introduction,which describes the research background of this thesis and its significance,composes the relevant literature,and proposes the research content and framework of this thesis.The second part is a theoretical analysis,which defines the three key concepts of urban-rural health insurance coordination,agricultural migrant population and long-term migration intention,introduces the theoretical basis of health insurance coordination policy affecting the long-term migration intention of migrant population,and qualitatively analyzes the possible influence mechanisms.The third part is the analysis of the current situation.On the one hand,it compares the development process of China’s basic medical insurance system,and on the other hand,it analyzes the current situation of migrating agricultural migrants in China and explores their migration decision motives and characteristics.The fourth part is the empirical analysis,which is also the focus of this thesis.A cross-sectional double-difference model is established based on the data of CMDS(National Mobility Dynamics Monitoring)in 2017,and the propensity score matching method is applied to overcome the possible endogeneity interference to study the impact of participating in urban and rural medical insurance coordination on the long-term migration intention of the agricultural mobile population,and an attempt is made to analyze the heterogeneity of the sample from four perspectives: age,mobility range,education level,and inflow region.Further,using the mediating effect research method,the mechanism of the effect of urban and rural medical insurance coordination policy on the long-term migration intention of the migrant population is explored.The fifth part is the conclusion and recommendation,which summarizes the findings of the previous analysis and proposes corresponding policy recommendations.The main conclusions of this thesis are: the urban-rural health insurance policy has a significant positive effect on the long-term migration intention of the agricultural migrant population,and this effect is mainly achieved by improving the social integration level of the migrant population;there is group heterogeneity in the effect of the urban-rural health insurance policy on the long-term migration intention of the agricultural migrant population,with the effect on the young-adult group being greater than that on the elderly;the effect on the inter-provincial migrant group is greater than that on the intra-city and inter-provincial migrant groups.The impact on cross-county and cross-province groups is greater than that of cross-city groups;the impact on groups with higher education level is greater;the impact on groups with inflow from eastern regions is greater than that of western and central regions.Based on the conclusions of the previous analysis,this thesis proposes that the level of urban and rural medical insurance coordination should be further improved to narrow the gap between urban and rural medical security;attention should be paid to the interests of disadvantaged groups and the construction of grassroots medical security should be strengthened;attention should be paid to the migration of the migrant agricultural population and labor mobility should be reasonably guided.