A Study On Poverty Reduction Effect Of The New Rural Cooperative Medical System On The Middle-aged And Elderly Rural Residents

China’s rural areas have always been the hardest hit by poverty.Among all the poverty-stricken factors,poverty caused by disease has always ranked first.In order to solve the problem of expensive medical treatment for rural residents and difficult medical treatment,China began to establish a pilot program for a new type of rural cooperative medical insurance system in 2003.The development has basically achieved full coverage,and the safeguard effect continues to increase.The implementation of the new rural cooperative medical system subsidizes the medical expenses of the participating residents.In theory,it can reduce the incidence of poverty,alleviate the poverty caused by the disease and return to poverty due to illness in rural areas.However,whether the above objectives can be effectively achieved in the specific implementation process still needs further evaluation and test.Based on the data of China’s health and pension tracking survey(CHARLS2011,CHARLS2013,CHARLS2015),this paper analyzes the poverty alleviation effect of NCMS in rural middle-aged and elderly populations.Firstly,using descriptive statistics to conduct longitudinal comparative study on data,we draw different regions.,the period and the different reimbursement ratio of the new rural cooperatives’ poverty alleviation effect;Secondly,using the binary logistic model to analyze whether the new rural cooperative medical system has a significant relationship with the poverty rate of rural middle-aged and elderly residents,and conduct poverty reduction effect assessment;Third,through the mediation effect model to test whether the incidence of catastrophic medical expenditure has a mediating effect between the new rural cooperative medical system and the poverty rate;Finally,based on the elimination of selectivity bias,the PSM propensity score matching method is used to further explore the effect of the implementation of the new rural cooperative medical system on the poverty alleviation and poverty alleviation of rural middle-aged and elderly residents in China.Through the research,the following four conclusions are mainly obtained:(1)Economic ability and health risk factors are important considerations for rural middle-aged and elderly residents to choose whether to participate in the new rural cooperative medical system,the lower the income level or the worse the health status,the more willing individuals to participate in the new rural cooperative medical system to resist the risk of serious illness,which reflects the problem of adverse selection in the behavior of participating in the new rural cooperative medical system.(2)The new rural cooperative medical system has played a certain role in alleviating the poverty caused by the disease,but it has not effectively achieved the expected policy objectives,according to the period,the mitigation effect of NCMS on poverty caused by disease in 2015 was higher than that in 2011 and 2013;By region,the new rural cooperatives have a better poverty reduction effect on the eastern region than the central and western regions;The proportion of reimbursement for the new rural cooperative medical system was divided,and it was found that with the increase in the proportion of reimbursement,the mitigation effect of the new rural cooperative medical system on poverty caused by disease was gradually enhanced.(3)The incidence of catastrophic medical expenditure has a significant intermediary effect between the new rural cooperative medical system and the poverty rate,indicating that the new rural cooperative medical system can affect the poverty rate by affecting the incidence of catastrophic medical expenditure,the incidence of catastrophic medical expenditure in the rural middle-aged and older groups was higher than that in the non-participating group,indicating that people with greater disease risk or those with weaker disease resistance were more willing to participate in the new rural cooperative medical system.(4)Based on PSM research and analysis,it is found that NRC has a positive impact on the incidence of poverty and the incidence of catastrophic medical expenditure among rural middle-aged and elderly residents,and the new rural cooperatives’ poverty reduction effect and the reimbursement ratio have a nonlinear relationship.In addition,because the Logistic model does not consider the selectivity bias,the effects of the new rural cooperatives’ poverty alleviation effect and the reduction of the incidence of catastrophic medical expenditure are overestimated to some extent.Rural residents have a relatively simple source of income,while rural middle-aged and older people generally have higher demand for medical and health services than other groups.It is the most vulnerable group.Studying the effect of NRCMS on the poverty reduction of middle-aged and elderly people in rural areas is conducive to improving the country.The fairness of the health care system reduces the risk of poor and weak people falling into long-term poverty.Based on the implementation status and empirical analysis of the new rural cooperative medical system,this paper proposes countermeasures from the perspectives of the government,insurance institutions,medical service providers and insured parties.