The Impact Of Medical Insurance On Healthy Behaviors Of Middle-aged And Elderly People

With the development of the society,a series of aging problems caused by the increase of the proportion of middle-aged and elderly population has become a difficult challenge at the present stage of China.Middle-aged and elderly people are disadvantaged groups with poor physical health,and the high cost of medical treatment leads to frequent occurrence of poverty due to illness,how to effectively improve the medical services utilization level of the middle-aged and elderly has become a hot topic of concern for the whole society.Medical insurance,as a means of compensation for consumers' economic loss when the medical expenses are incurred,will release the medical services demand by reducing the proportion of the family self-paying medical expenses,and improve the health of patients finally;besides,medical insurance may have a positive effect in preventive care,and reduce the incidence of underlying disease.In China,the social basic medical insurance system has been gradually reformed and improved,urban and rural resident medical insurance has taken an important step in eliminating the difference between urban and rural areas,serious illness insurance enters the life of residents and works well,however,the development level of commercial supplementary medical insurance is still relatively low.Therefore,this article will examine and compare the effect of two kinds of medical insurance on healthy behaviors,and provide references for the reform of medical insurance system in China.Concept of healthy behaviors is generalized,specifically including:medical services utilization,preventive care and moral hazard.First of all,this paper reviews the relevant literature and summarizes the research methods and conclusions.After that,the Andersen health services utilization model and theory of moral hazard,which is the theoretical basis of this paper,is introduced.Finally,through the three-periods panel data of China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2015,we use Heckman,panel Logit,Ordered Probit and panel Fixed Effects models to empirically measure the impact of social basic medical insurance and commercial supplementary medical insurance on healthy behaviors of middle-aged and elderly people.The main conclusions of the paper are as follows:firstly,medical insurance has a positive effect on the utilization rate of outpatient and inpatient services,compared with the non-medical insurance,the total outpatient expenditure of the middle-aged and the elderly who participate in the social basic medical insurance will increase by 45.9%significantly at the 1%level,and who purchase commercial supplementary medical insurance will increase by 71%significantly at the 1%level,it indicates that the effect of commercial supplementary medical insurance is greater than that of social basic medical insurance,but medical insurance doesn't have significant effect on total inpatient expenditure.The promotion of medical insurance on the medical services utilization of the middle-aged and elderly is different between urban and rural areas,and between regions;besides,medical insurance increases the possibility of selecting a higher level medical service provider in the treatment of the middle-aged and elderly.Secondly,commercial supplementary medical insurance significantly reduces the possibility of smoke by 3.09%and increases the possibility of drink by 3.27%,we can't make sure existence of ex-ante moral hazard.However,the possibility of physical exercise after participating in social basic medical insurance is promoted by 4.13%,it shows the social basic medical insurance has played a positive role in the healthy lifestyle of the middle-aged and elderly.Thirdly,both social basic medical insurance and commercial supplementary medical insurance don't cause ex-post moral hazard of outpatient treatment in the middle-aged and elderly.In addition,from the relationship between education and consumption,the non-medical consumption expenditure of the family is positively promoted by the education of middle-aged and elderly people.