Research On The Influence Of Social Medical Insurance On Medical Expenditure Of Urban Elderly

The elderly are the most vulnerable to disease and one of the main groups of medical and health service consumption.In the context of population aging and aging,the proportion of medical expenditures of the elderly in China's total medical expenditures continues to rise,and the burden of medical expenses is heavy.The phenomenon of “poor illness due to illness” and “returning to poverty due to illness”has frequently occurred in elderly families.The main purpose of medical insurance is to reduce the uncertainty of residents after illness and enhance their ability to withstand catastrophic medical expenses.Whether medical insurance can improve the accessibility of residents' medical services and reduce the medical burden of residents' families is an important indicator for measuring the target of medical insurance.Therefore,it is necessary to study the medical expenses and medical security of urban elderly in the context of China's aging,in order to provide reference for the promotion of more equitable access to basic medical security rights and continuous optimization and improvement of the medical insurance system.This paper selects the data of “Chinese Longtitudinal Healthy Longevity Survey”(CLHLS)in 2014.It mainly discusses two issues: First,how does social medical insurance affect the total medical expenditure of urban elderly;second,whether various social medical insurances are alleviated.What is the difference between the impact of different types of medical insurance policies on the self-paying medical expenses of the elderly? This paper first describes the current situation of medical expenditure for the elderly in China and the basic medical insurance participation,and on this basis,using Duan's two-part model and Heckman sample selection model to estimate the impact of medical insurance on the total medical expenditure of the elderly;At the same time,two models were used to estimate the impact of medical insurance on the self-paying medical expenses of the elderly.The specific research idea is to select the total medical expenditure and the out-of-pocket medical expenditure in the past year as the explanatory variables of this paper,and select public medical care,urban employee medical insurance and urban resident medical insurance as the explanatory variables of this article,with no reference to social medical insurance.Items,select prerequisites(age,gender,marriage,education,type of residence,number of children),ability factors(family income,place of residence,region),demand factors(daily activity ability,self-rated health,whether chronic diseases)Control variables to study the impact of health insurance on total medical expenditures and out-of-pocket medical expenses for the elderly.Through empirical analysis,the paper draws the following conclusions: First,social medical insurance has a promoting effect on urban elderly for medical treatment.Participating in medical insurance has significantly increased the totalmedical expenditure of the elderly.Second,different types of medical insurance policies have different effects.Public medical care has a significant effect on reducing the medical burden of urban elderly people.Urban employment insurance and urban residential insurance have little effect on reducing the self-paid medical expenses of the elderly.Third,among other control variables,factors such as economic income,region,and especially health factors also affect the total medical expenditure and self-paying medical expenses for the elderly.Based on the above conclusions,this paper proposes the following countermeasures: First,expand the coverage of social medical insurance and improve welfare;Second,integrate the social medical insurance system and medical resource allocation,narrow the differences in the level of different medical insurance protection,and improve fairness.Third,strengthen the health management of the elderly and achieve a healthy aging.