Research On The Effect Of New Rural Cooperative Medical System On The Health Level Of Rural Residents And Poverty Alleviation

China’s rural residents are faced with high health risks.The problem of poverty and return to poverty due to illness has been prominent in rural areas,and rural medical security is facing great pressure.China began to implement the new rural cooperative medical system in 2003,and gradually spread throughout the country,the level of medical insurance benefits and beneficiaries increased year by year.The implementation of the new rural cooperative medical system(NCMS)has significantly reduced the out-of-pocket medical expenses of the insured residents,which can theoretically reduce the economic burden of the residents and improve the health level of the residents,thus alleviating poverty.So,in the course of practice in recent years,whether the new rural cooperative medical scheme(NCMS)has achieved the goal of improving the overall health level of rural residents and alleviating the poverty situation of residents,and what kind of differences will emerge in the institutional effects for groups with different characteristics,what are the influencing mechanisms behind these effects,and the answers to these questions will contribute to the improvement and development of the medical insurance system in rural areas,as well as to the promotion of healthy poverty alleviation in rural areas,therefore,this paper needs to be evaluated and tested at the theoretical and empirical levels.Based on the latest data of Chinese household follow-up survey,the effects of NCMS on improving health level and reducing incidence of poverty among rural residents were analyzed.Firstly,the theoretical mechanism of the effect of the new rural cooperative medical scheme(NCMS)on the general health level and poverty status of rural residents was analyzed theoretically.Secondly,we use OLS regression model to carry on the preliminary regression analysis,and get the influence degree of the medical insurance to the health level of the rural residents,then we analyze the influence mechanism of the new rural cooperative medical system(NCMS)on health level,and analyze the difference of the influence of medical insurance from four aspects: age,sex,income level and geographical distribution.Thirdly,the effect of medical insurance on the poverty of rural residents is analyzed by using the binary regression model,and the bias of sample selection is eliminated by the method of propensity score matching,and then analyze the influence of medical insurance on the poverty of rural residents in different age,sex,health level and region.Finally,the mediating effect model was used to test whether the health level played a mediating role between the participation of NCMS and the poverty status.The paper is divided into seven parts:The first chapter is the introduction.Firstly,it reviews the development history of the new rural cooperative medical scheme(NCMS),and analyzes the research background and significance of this paper;and then summarize the technical route,research methods and research contents used in this paper.Finally,the main innovation and deficiencies of the paper are explained.The second chapter reviews the institutional effect,health level and poverty alleviation effect of medical insurance.The third chapter is related to the concept and theoretical basis.Firstly,this paper defines the core concepts of the new rural cooperative medical system,health and poverty.Secondly,the theoretical basis of this paper includes the theory of public goods supply,the theory of health demand and the theory of poverty.Thirdly,this chapter is the theoretical analysis of the impact of medical insurance on health level and poverty alleviation.By mapping the impact mechanism,the paper theoretically analyzes the mechanism of the new rural cooperative medical system(NCMS)to improve the overall health level,and then theoretically analyzes the theoretical mechanism of the NCMS to promote the rural residents to escape poverty.The fourth chapter is the empirical analysis of the impact of medical insurance on the health level of rural residents,through constructing OLS regression model and tool variable model and selecting the Chinese household tracking survey 2018 rural sample data,select the appropriate variables for regression analysis,and on this basis,use the instrumental variable method to solve the endogenous problem,and then make an empirical analysis of the impact mechanism,finally,from the age,sex,income level and geographical distribution of four aspects of heterogeneous impact analysis,and draw the corresponding conclusions.The fifth chapter is the empirical analysis of the impact of medical insurance on rural residents’ poverty alleviation.In this chapter,we still use China household tracking data 2018 rural sample data,construct empirical model and choose appropriate variables to analyze the impact of health insurance on poverty reduction.Then based on the basic regression,the method of propensity score matching is used to test the robustness.Finally,we analyze the difference of the influence of medical insurance on rural residents’ poverty alleviation in different age,sex,health level and region,and draw the corresponding conclusion.Based on the empirical regression in the first two chapters,the sixth chapter theoretically analyzes the theoretical path of health level as an intermediary effect between the participation in the NCMS and the alleviation of poverty,and then we construct the model of mediating effect and make empirical regression to test the mediating effect mechanism of health level.The seventh chapter is the research conclusion and policy suggestion.This chapter summarizes the effect of the new rural cooperative medical system on health level and poverty alleviation,and puts forward a series of practical reform proposals.