Air Pollution,Residents’ Concerns And Commercial Health Insurance

Since the emergence of several serious haze phenomena in China,air pollution has become a hot issue of concern for the country’s residents.Air pollution is not only related to the country’s image and economic growth,but also a constant threat to public health.According to the 2019 national air quality released by China’s Ministry of Ecology and Environment,the number of cities meeting ambient air quality standards among the country’s 337 prefecture-level cities accounted for 46.6 per cent of the total,compared to 24.85 per cent in 2016,a considerable improvement but still not more than half.The Party has also made it clear in its 14th Five-Year Plan that it will continue to improve the quality of the environment,enhance the awareness of ecological and environmental protection in society as a whole,and fight the battle against pollution in depth.In order to circumvent physical illnesses brought about by air pollution as well as illnesses induced by other causes,the demand for commercial health insurance has been rising among Chinese residents,which in turn has contributed to the rapid expansion of the commercial health insurance market in China.From 2010 to 2020,China’s commercial health insurance market grew from 67.75 billion yuan to 817.3 billion yuan,an increase of about 12 times.2014 saw the State Council issue "Several Opinions on Accelerating the Development of Commercial Health Insurance",which clearly proposed to accelerate the development of commercial health insurance,enrich the types of products and enhance the organic connection with basic medical insurance.It can be seen that commercial health insurance is valued and supported by the state.As an important part of China’s social security system,commercial health insurance can compensate residents for the increased financial burden caused by injuries and illnesses,while medical insurance provides basic protection for residents,commercial health insurance reduces medical costs for residents.Based on this background,this paper uses micro household data and macro prefecture-level city data to investigate the impact of air pollution on household participation purchase and participation in commercial health insurance,and the impact of air pollution on macro demand for commercial health insurance,respectively,while exploring the indirect impact of residents’ concerns between air pollution and commercial health insurance.The innovations of this paper are mainly reflected in the following points.Firstly,this paper examines the impact of air pollution on commercial health insurance from a micro household perspective and a macro prefecture-level perspective,which includes macro and micro perspectives,making the study more comprehensive and novel.The micro perspective is the first to separate long-term care insurance from commercial health insurance and to analyse the impact of different types of pollutants and different time windows.Secondly,in terms of endogenous treatment,this paper uses the relatively novel ’inverse temperature instrumental variable’ and the ’Qinling and Huaihe quasi-natural experimental design’,two cutting-edge approaches to study the impact of air pollution on commercial health insurance.The use of appropriate instrumental variables or research methods makes the results of the study more realistic and robust.Again,in terms of influence mechanism,this paper explores the "air pollution-residents’ concern-commercial health insurance" influence mechanism from the perspective of residents’ concern in the research system of air pollution on commercial health insurance,in which residents’ concern is also the first time to include Baidu index,pollution reporting and anti-haze behaviour.Finally,compared to the traditional ground-based monitoring station data and industrial emission data,this paper uses the latest satellite remote sensing monitoring PM2.5 data,which is more objective and intuitive than ground-based monitoring data,and avoids manipulation and errors.The specific empirical studies are organised as follows.Chapter 4 examines the impact of air pollution on commercial health insurance micro-participation.Based on the 2019 version of CHFS household microdata,this section combines PM2.5 and inverse temperature data,and uses Probit,Tobit,Ⅳ-probit and Ⅳ-pobit regression models to estimate the impact of air pollution on household commercial health insurance participation behaviour,and the regression results are analysed according to different types of air pollutants,different time windows,different groups and different geographical areas Heterogeneity analyses were conducted,and finally robustness tests were performed using core explanatory variables replacement and exclusion of selection bias.Chapter 5 examines the impact of air pollution on macro demand for commercial health insurance.Based on macro data for 81 prefectures in the Qinling and Huaihe region from 2011 to 2019,this section uses FE regression models,fuzzy breakpoint regression models and quasi-natural experiments on centralised heating policies in areas north of the Qinling and Huaihe in China to estimate the impact of air pollution on the demand for residential commercial health insurance in China,and heterogeneity analysis of the regression results according to the year-by-year analysis method to discuss the different yearly scenarios of air pollution affects residents’ demand for commercial health insurance to make the study results more complete and detailed,and finally robustness tests are conducted according to the prescribed method of breakpoint regression.Chapter 6 examines the indirect effects of residents’ concerns on commercial health insurance.Based on the empirical models in Chapters 4 and 5,this section investigates the impact mechanisms of air pollution,residents’ concerns and commercial health insurance using Ⅳ-probit,Ⅳ-tobie,RDD and Ⅳ-FE models,in which residents’ concerns are divided into Baidu index,pollution reporting and anti-haze behaviour for the study to explore the different potential impact channels,and finally replacing the core explanatory variables for Robustness tests were conducted by replacing the core explanatory variables.In summary,the empirical results validate the findings of the positive impact of air pollution on household commercial health insurance participation behaviour and the positive impact of air pollution on the demand for commercial health insurance at the prefecture level.The analysis of the impact mechanism of air pollution on commercial health insurance with residents’ concern as a potential impact channel is also tested in terms of the impact mechanism,which validates the role of the mechanism of residents’ concern and the different types of residents’ concern The article also examines the mechanism of air pollution as a potential channel of influence on commercial health insurance.Finally,the article presents the conclusions and future prospects of the study.Firstly,the basic findings are summarised,and secondly,systematic policy recommendations are made with regard to the specific empirical findings:it is also necessary to take into account regional differences and air pollution in the development plans and innovations of commercial health insurance,which will help the healthy development of the commercial health insurance market;the state strengthens residents’ awareness of environmental protection and their own health protection,and government departments can also strengthen their awareness of environmental protection and safety.Medical institutions and insurance institutions can also take advantage of their own strengths and set up "health management"departments to guide residents to pay attention to and protect their own health,as well as to reduce their medical costs,thereby reducing the impact of air pollution on different groups of people.In this way,it will help to reduce the impact of air pollution on different groups of people,which will be conducive to the implementation of the Health China Strategy and the building of a happy life for the residents.Financial institutions can provide enterprises with green financial services that are conducive to environmental protection,environmental improvement and energy conservation,helping them to replace old and new energy sources and promoting the treatment of pollutant emissions;insurance institutions can develop green insurance to make positive explorations and contributions to enterprises’ efforts to strengthen environmental pollution risk management,reduce pollution accidents and protect the interests of environmental pollution victims...