The Effect Of Social Basic Medical Insurance On The Health Of Migrantrural Workers

In the report of the 19th National Congress of the Communist Party of China,general secretary Xi Jinping carried out the Healthy China initiative.The report points out that "A healthy population is a key mark of a prosperous nation and a strong country.We will improve the national health policy,and ensure the delivery of comprehensive lifecycle health services for our people ".The migrant rural worker is an important force in building China,promoting economic development and serving the people,and an important promoter of China's rapid economic progress in recent years.According to statistics,the total number of migrant rural workers in 2018 is 288.36 million,accounting for about 20%of the total population of the whole country.The number is huge and the number is also increasing year by year.More than 60%of the migrant rural workers engaged in manufacturing,construction,retail and wholesale,and their working environment,living conditions are relatively poor.The migrant rural worker are easily ignored by us in personal health,medical and health services.Therefore,under the background of the Healthy China initiative,it is of great practical significance to study the health level of migrant rural workers.According to statistics,the number of people participating in the national social basic medical insurance in 2018 has reached 1.34459 billion.The participation rate has stabilized at more than 95%and the national social basic medical insurance basically achieved full coverage,but there are still some people who do not have social basic medical insurance.Because the awareness of insurance is not strong,and the reimbursement of medical treatment in different places is cumbersome,some migrant rural workers do not have insurance.Whether having social basic medical insurance can really improve the health level of migrant rural workers is worth further study.Using data from china health and old-age tracking survey(CHARLS)in 2013 and 2015,this paper first uses ordered probit model,draws lessons from zhao shaoyang et al.(2013)research on health status of "sandwich class",zhao zhong(2006)research on rural population health by new rural cooperative medical system,takes self-assessment health as explained variable.Then this paper selects daily behavior ability as explained variable to study the impact of social basic medical insurance on migrant rural workers' health after controlling for variables such as education,drinking,age,sex and marriage.Then,heterogeneity was analyzed according to the educational level and gender.Finally,the self-assessment health was set as a binary variable,and the fixed effect logit model was used for empirical analysis as a robustness test.The empirical results show that:(1)when taking self-assessment health as the explained variable,the absence of social basic medical insurance will increase the probability of migrant rural workers' self-assessment health status as "very bad" and"bad" by 1.3%,1.1%;having social basic medical insurance will increase the probability of their self-assessment health status as "very good" by 1.7%,which is statistically significant.When the basic daily activity ability is taken as the explained variable,the probability that there is no social basic medical insurance will make its basic daily activity ability state "unable to complete","difficult,can complete" is significantly increased by 3.3%,2.7%.All above show that having social basic medical insurance can really improve the health level of migrant rural workers.Having basic social health insurance has a significant positive effect on the health status of migrant workers.(2)According to the analysis of heterogeneity,the social basic medical insurance has a lower impact on migrant rural workers in primary schools and below,regardless of their self-rated health status.The impact of social basic medical insurance on female migrant workers is generally higher than that of male migrant workers.Having social basic medical insurance will increase the probability of self-rating health status of migrant rural workers in primary schools and below as "good" and "very good" by 1.1%and 2.3%;without social basic medical insurance,the probability of female migrant rural workers self-rating health status as "very bad" and "bad" by 1.6%and 1.3%.It can be seen that the social basic medical insurance has the greatest impact on the health of female migrant rural workers with an education level of primary school and below.(3)Using a fixed-effect logit model,it was found that having basic social health insurance significantly improved their health and passed the robustness test.According to the findings of this paper,the following recommendations are proposed:increasing publicity and popularization efforts to enhance the concept of migrant workers to pay attention to insurance;perfecting the policy of seeking medical treatment in different places and establishing a unified reimbursement system for medical treatment in different places;continuously improving the overall level of social basic medical insurance and expanding the scope of reimbursement for social basic medical insurance;establishing a standardized and unified information system for social basic medical insurance;expanding the level of basic medical insurance and continuing to raise the standard of subsidies.