Research On Poverty Reduction Effect Of New Rural Cooperative Medical System From The Perspective Of Health Heterogeneity

Accurate poverty alleviation is one of the three major battles for China to win the all-round construction of a well-off society.It is an important task for the whole society to get rid of poverty for all rural poor people in the past and even in the future.Disease is the most important cause of poverty in China at present.With the deepening of poverty alleviation,the proportion of people who suffer from disease and return to poverty in the total poverty population has been repeated in recent years,and even increased in some years.It increased from 42.2% in 2013 to 44.1% in 2015,involving nearly 20 million people,while in 2019,it was 41.3%,a decrease of only2.8%.It can be seen that solving the problem of poverty caused by illness and returning to poverty is not only the key and difficult point of China's accurate poverty alleviation,but also a major test to realize the strategic goal of "real poverty alleviation and real poverty alleviation".In this context,in order to reduce the medical economic burden of farmers and improve their health,the Chinese government began to implement the new rural cooperative medical system(NCMS)in 2003.Since its implementation,the new rural cooperative medical system has developed rapidly,the number and proportion of insured people have increased by a large margin,and the level of medical compensation and the number of compensation beneficiaries have also been continuously improved.To a certain extent,this has promoted the organic combination of insurance and rural population poverty reduction goals,and realized the function and value of the new rural cooperative medical system in poverty reduction.In view of this,on the basis of theoretical analysis and empirical research,based on the poverty theory and the poverty reduction theory of NCMS,this paper constructs the expected poverty vulnerability theoretical model,specifically measures the poverty vulnerability of micro families,and verifies the impact of NCMS on poverty vulnerability.At the same time,the intermediary variables of medical expenditure,medical self payment rate and labor supply are introduced to analyze the transmission mechanism and channel of the impact of NCMS on poverty vulnerability.Based on this,we established a health heterogeneity test model to analyze the heterogeneity of NRCMS on poverty vulnerability,and simultaneous interpreting the health heterogeneity of NCMS poverty alleviation channels,in order to draw a more comprehensive mechanism for NRCMS to reduce poverty.Finally,this paper puts forward specific and feasible policy suggestions on how to further give play to the poverty reduction effect of NCMS,protect farmers' health problems,and how to promote rural medical insurance to accurately get rid of poverty.In this regard,this study will be carried out from the following two aspects:First,the theoretical research on poverty reduction of NCMS.This part mainly uses the family asset accumulation model to explain the relationship between the new rural cooperative medical system,family health level and family poverty vulnerability,mainly including health demand theory,poverty and poverty trap theory,and deduces the changes of family asset accumulation under the condition of insured and uninsured from the family asset accumulation theoretical model,Then the change law of family poverty vulnerability is obtained.Second,from an empirical perspective,this paper studies the poverty reduction effect of NCMS,the intermediary effect of poverty reduction,and whether there is health heterogeneity in poverty reduction.Firstly,this study focuses on the core explanatory variable of the poverty reduction effect of NCMS-poverty vulnerability.Secondly,the direct effect model is used to verify the impact of NCMS on poverty vulnerability,and to analyze the transmission mechanism in the process of poverty reduction.Finally,the heterogeneity of poverty reduction effect of NCMS is studied in detail by introducing health status variables.The main results of this paper are as follows: first,the new rural cooperative medical policy has a significant poverty reduction effect on poor families,especially when the premium is fully covered,it has a positive effect on reducing family health risk,and then significantly affects family poverty vulnerability.At the same time,families with poor health can maximize the compensation for premium loss,effectively reduce the impact of family health risk on family economy and avoid the phenomenon of "poverty due to illness".Second,family characteristic variables have a significant impact on family poverty vulnerability,but there are significant differences in the impact of different family characteristic variables on family poverty vulnerability.Among them,the participation of basic old-age insurance and medical insurance has a significant impact on family poverty vulnerability,and the poverty vulnerability under insurance is significantly lower than that under insurance.Third,the impact of NCMS on poverty vulnerability is significantly negative.Participating in NCMS can significantly reduce poverty vulnerability.Fourth,the mediating effect of NCMS on poverty reduction shows that medical expenditure,medical out of pocket rate and labor supply variables play a significant mediating role in the poverty reduction effect of NCMS.Fifth,there is significant health heterogeneity in the poverty reduction effect of NCMS,and the poverty reduction effect of NCMS on poor health is more significant.At the same time,there is significant health heterogeneity in the transmission effect of NCMS on poverty reduction under different intermediary variables.The main innovations of this study are as follows: first,the perspective of innovation.Based on the heterogeneity of different family health status,this paper considers to study the heterogeneous impact of NCMS on family poverty reduction from the health status,so as to expand the research content on the poverty reduction effect of NCMS.Second,content innovation.This study not only analyzes the poverty reduction effect of NCMS,but also deeply analyzes how the intermediary variables affect the poverty reduction effect of NCMS;At the same time,this paper tests the heterogeneity of the conduction role of different intermediary variables in the process of NCMS poverty reduction.Third,method innovation.This study constructs a multidimensional expected poverty vulnerability model,and analyzes the poverty reduction effect of NCMS combined with family health heterogeneity,which enriches the theoretical research of poverty vulnerability.Based on the above analysis and research basis,this paper puts forward the following policy suggestions: implement differentiated new rural cooperative medical system policy,give different security policies to families under different health levels;re-examine the role of new rural cooperative medical system in poverty reduction from the national strategic level,pay more attention to the role of poverty reduction effect of new rural cooperative medical system in poverty reduction of families in underdeveloped areas such as central and Western China;attach importance to new rural cooperative medical system We should innovate poverty reduction products and improve the overall efficiency of poverty reduction through insurance.