Research On The Influence Of Basic Medical Insurance On People's Sense Of Gain

Since the reform and opening up,especially the 18 th national congress of the communist party of China(CPC),China's basic medical insurance system has entered a period of rapid development.As an important livelihood project in China,it carries a huge investment in China and is highly valued by the party and the country.It is also related to the well-being and subjective feelings of the people.However,the implementation effect of the basic medical insurance policy has been discussed in a large number of literatures,mainly from the system coverage rate,replacement rate,residents' satisfaction,happiness,medical service utilization rate,health level and other indicators for evaluation,and rich results and experience have been obtained.The word "sense of gain" originated from President xi 's speech at the 10 th meeting of the central leading group for comprehensively deepening reform on February 27,2015.In the report to the 19 th national congress of the communist party of China(CPC),it was explicitly proposed to "make people's sense of gain,happiness and security more substantial,more secure and more sustainable".Today,in the speeches of state leaders,in important meetings and other occasions,the sense of gain has become a "high-frequency word",gradually consolidating its position as a "litmus test" for China's development achievements and reform effects.It is of great theoretical and practical significance to evaluate the implementation effect of China's basic medical insurance by taking the sense of gain as a yardstick and to clarify the relationship between the participation in basic medical insurance and the people's sense of gain and its internal mechanism.Based on the study and summary of the literature,this paper divides the people's sense of gain into sense of economic gain,sense of public service gain,sense of political gain and sense of development opportunity gain,constructs the index system of people's sense of gain,and introduces micro data to measure it.Based on the data of the 2015 China General Social Survey(CGSS2015),this paper takes the participation behavior of basic medical insurance as the main research object,and uses the propensity score matching method(PSM)to eliminate the selective bias and conduct an empirical study on the impact of basic medical insurance on the public's sense of gain.It is found that :(1)Participating in the basic medical insurance has no obvious effect on the sense of economic gain of all the samples.(2)Participation in the basic medical insurance significantly improved the sense of public services gain of the whole sample,urban sample and low-income sample,but it did not significantly affect the sense of public services gain of the rural sample,the middle-income sample and the high-income sample.(3)Participating in the basic medical insurance has an obvious positive effect on the sense of political gain of the whole sample,the urban sample and the low-income sample,but it has no obvious effect on the sense of political gain of the rural sample,the middle-income sample and the high-income sample.(4)Participation in the basic medical insurance failed to effectively enhance the sense of development opportunities gain of all the samples.Based on the empirical results and theoretical analysis,the following policy suggestions are put forward :(1)Continue to accelerate the reform of the " Three medical linkage " mechanism,enhance the voice of medical insurance in the field of medical services,enhance the professional and scientific construction of medical insurance teams,and improve the supervision ability of medical insurance institutions over medical institutions.(2)Advancing the reform of the mode of medical insurance payment,improving the service agreement management and assessment of designated medical institutions of basic medical insurance,enhancing the role of medical insurance in stimulating and restricting medical services,and enhancing the ability of basic medical insurance to control excessive growth of medical and medical expenses.(3)Improve the policy design of medical insurance benefits and improve the actual reimbursement level of medical insurance.To increase the people's sense of economic gain.(4)Increase the input of medical insurance funds into rural and the basic level areas,guide the sinking of high-quality medical service resources,and improve the accessibility and utilization rate of high-quality medical services to residents in rural and the basic level areas.(5)Ensuring that low-income and poor groups do not lose insurance coverage;When they cannot timely pay the medical insurance expenses due to their low income,they shall be subsidized and assisted to keep them insured;Strengthen the publicity of medical insurance policy so that it does not abandon insurance.(6)Accelerating the development of a medical security system at all levels and encouraging the development of commercial medical insurance to meet the medical service needs of middle-income and high-income groups at higher levels.To improve people's sense of public services gain.(7)Continue to optimize the services handled in rural areas and improve the quality of medical insurance services.(8)Accelerate the construction of medical insurance informatization and provide high-quality and convenient services.To enhance the public's sense of political gain.(9)Continue to integrate the basic medical insurance system and achieve national pooling.(10)Improve the mechanism for transferring and continuing medical insurance,reduce transaction costs and benefits losses when people's medical insurance accounts are transferred,and ensure reasonable employment and intergenerational mobility.(11)Improve the functions of the national medical settlement system in different places,and fully protect the medical security rights and interests of the floating population and other groups.To enhance the people's sense of development opportunities gain.