Research On The Health Expenditure Of Urban And Rural Residents In The Background Of Population Aging

With the increase of life expectancy, the aging population regarded as the “silver wave” has become an important issue of economic and social development in China.As of the end of 2014, China’s elderly population aged 60 and above has reached 212 million, accounting for 15.5% of the total population. By 2025, the elderly population is expected to reach 308 million, accounting for 21.1% of the total population. The elderly are China’s futuristic largest health vulnerable groups. Under the circumstances that the population aging and advanced age-rization is increasingly grim, that how to better improve the elderly people’s quality of life and quality of livelihood and let them enjoy the old age life, has become the focus of attention of the society. In many factors that affect the quality of livelihood of the elderly, health always has played an important role. With the rapid aging of Chinese population, the pressure of health care services will continue to increase. Whether the young health elderly, or the elderly with the sick into old age, their demands for health care services and intermediate medical services are growing. In the foreseeable future, China will usher in a period of high burden on the elderly, and the health expenditure, which is an important livelihood issues will become more prominent.‘That it is difficult and expensive to see a doctor’ has been a prominent problem troubled urban and rural residents, and that is also a weak link in terms of Chinese social construction. The paper uses the health expenditure of urban and rural residents under the background of the aging of the population as an entry point,From macroscopic view, the overall arrangements of the medical and health system need to ensure that residents reasonable medical needs are met; In microcosmic aspect,under the precondition of ensuring the quality of medical service, we should inhibit the medical information superiority, eliminate or slow down hospital induced demand, control unreasonable increase of medical expenses. This paper explores the problem of medical and health expenditure of urban and rural residents under the background of population aging from above two aspects. From the empirical results of the macro data, the income level of urban and rural residents has important influence on their own medical care expenditure. That young population bring up ratio is decreasing, make more Chinese families’ population production preferences change from the previous quantity to the quality of the population which pay more attention to human capital investment, and then by the increase of health careexpenditure, to promote the population’s “fewer and healthier births”, and the continuing evolution aging process significantly increases the residents’ health care expenditure. As far as the differences of the health care consumption expenditure between urban and rural was concerned, because of the more serious aging population and the lower income level in rural areas, the health care consumption expenditure is more than urban areas. And with the advent of the tide of population aging in China,in the future, China’s population total dependency ratio and health-care spending will show significantly positive correlation, and there is a long way to go to build a society that welfare of residents are gradually increasing. The empirical results from the micro data CLHLS show that, although social medical insurance, to some extent, can alleviate the medical expenditure of the insured person, the medical insurance has distorted the medical service quality, and it affects patient’s medical demand through a variety of mechanisms, then may lead to moral hazard. A higher level of medical insurance coverage will increase the demand for medical services, which means that there is an ex post moral hazard in medical insurance. According to the propensity score matching(PSM) method to control other factors, in addition to insurance, to observe that whether to participate in medical insurance or not how to affect medical expenses of the elderly. Results reveal that, the elderly participate in medical insurance, in a certain extent, reduce the pocket medical expenses, but medical insurance can not reduce their total medical expenditures, and it instead increase the elderly total medical expenditures, which indicates that medical insurance will increase the spending on the elderly, as well as the reimbursement, and which verify the existence of moral hazard in medical insurance. At the same time, the basic drug policy did not reduce the medical expenses of the elderly, on the contrary, it increases the medical expenses of the elderly. The basic drug policy has a more significant impact on the elderly not involved in health insurance or who are in rural areas. The basic drug policy does not solve the problem “that it is expensive to see a doctor”,which is urgent to be resolved. The countermeasures and suggestions are as follows:First of all, we should actively promote the sustainable growth of resident income in urban and rural, and strive to enter the high level stage of economic development. meanwhile, the development should be in a more equitable direction.which is the core strategy of China to deal with aging. Due to the consumption of health care is a higher level consumption, and family income is also the important factors which affect the residents health care expenditure, so the residents’ health careconsumption level closely related to family income level. At the same time, the difference of income level between urban and rural areas can cause the health inequality of urban and rural residents to a certain extent, which also makes it becomes inevitable that there is a difference in the health care consumption expenditure(demand) between urban and rural residents. And the medical consumption of low income household accounts for a large share in life consumption,which affects the improvement of quality of life. The widening income gap also affects the further consumption of low-income households in health care. Therefore,under the background of population aging, the increase of the consumption expenditure of urban and rural residents’ health care need be based on the sustainable growth of income level and equity.Secondly, in the context of accelerated urbanization, the problem of rural aging should be paid more attention. Therefore, it is necessary to carry out a wide range of elderly health education to promote the concept of health care gradually from “the type of cure” turn to “health care” to nip in the bud. At the same time, characteristics of unbalanced financial allocation of health resources between urban and rural areas force the rural residents’ health care to depend on family too much, which leads to the lack of other household consumption demand. Therefore, it is necessary to strengthen the responsibility of government in the rural health investment.In the end, the medical model of modern society should turn from post treatment to the prevention of pre-post treatment, and the demand of medical services should be also evolving from the low level of "disease needs" to the high level of "health needs".The realization of health depends on not only the arrangement of the medical insurance system, but also benefit from the conscious efforts of the individual. With the change in the pattern of disease,the boundaries between health and disease are increasingly blurred, and we tend to emphasize the medical supply with better returns and ignored prevention service supply with the strong publicity. With the increase of aging population, medical care for treatment of aging population disease needs to be strengthened, and the preventive health services for elderly will also be the direction of future development.