The Impact Of Medical Insurance Contribution Compensation Mechanism On The Utilization Of Medical Services For The Elderly

The current basic medical insurance system in China mainly includes urban and rural residents’ medical insurance system and urban workers’ medical insurance system.The integration of the basic medical insurance for urban and rural residents has realized the specific goal of perfecting the basic medical insurance system covering urban and rural residents and making everyone enjoy the basic medical insurance in China’s new medical reform plan.The difference between the urban employee medical insurance system and the urban and rural resident medical insurance system is mainly reflected in the construction of the elderly after retirement payment mechanism and the establishment of the medical insurance compensation scheme.At the same time,the behavior of the insured to use the medical service is related to the basic medical insurance payment and compensation mechanism.On the one hand,the economic compensation of medical insurance can enhance the ability to pay the medical expenses of the insured,release their demand for medical services,and enrich the choice of medical services of the insured.On the other hand,it may lead to overuse of medical services.Compared with other insured groups,the retired elderly have a stronger demand for medical and health services,and the elderly are more sensitive to the reimbursement ratio of medical insurance.Therefore,the study on the health use behavior of the retired elderly can better reflect the influence of the medical insurance contribution and compensation mechanism on the utilization of health services.However,the current research on the mechanism of medical insurance contribution compensation and the utilization of health services for the elderly is insufficient,the quantitative analysis is insufficient,and the corresponding objective estimation is even less.At the same time,in our country to build the journey of "universal coverage",a variety of medical insurance system coexist,ginseng protect subject differences,financing way and the proportion is different,lead to provide different compensation scope,covering the diseases,compensation of medical services and medicines directory difference is bigger,affect the accessibility of health service and efficiency.It can be seen that the impact of medical insurance contribution and compensation mechanism on the utilization of medical services for the elderly is worth further discussion.To this end,this paper chooses Chinese family tracked 2016,2018,the two data,retired people in town as the experimental group,towns,and urban and rural old people over 60 employees as the control group,and utilization of our country town retired worker,on-the-job worker and over 60 years old residents pay cost compensation mechanism,establish a triple difference model,as measured by the past year total health expenses empirically town worker pay and compensation policy for the elderly health service utilization.The main conclusions of this paper are as follows:First,the contribution and compensation mechanism of medical insurance for urban workers has a significant promotion effect on the medical expenses of the retired elderly.After the retirement of the elderly who participate in the medical insurance for urban workers,the total medical expenses increase by 43.82% to 76.80%.The out-of-pocket part of medical expenses significantly decreased by 45.86%,while the part of medical expenses compensation significantly increased by 48.46%,which indicated that the increase in the total medical expenses was not caused by the increase in the out-of-pocket part of individuals,but by the increase in the proportion of compensation after retirement.Secondly,the contribution and compensation mechanism of basic medical insurance has different effects on the utilization of medical services among different groups.After retirement,the level of medical expenditure of urban workers of low,medium and high income levels increases by 107.05%,80.14% and 43.22% respectively,which confirms Hypothesis 2.That is to say,the contribution and compensation mechanism of medical insurance has a more significant effect on the increase of medical expenses of retired workers in the middle and low income group.Thirdly,the contribution and compensation mechanism of basic medical insurance promoted the utilization of medical services for the retired elderly in the eastern,central and western regions,which were 34.88%,insignificant and 97.03%,respectively,indicating that the contribution and compensation mechanism of medical insurance had a greater influence on the utilization of medical services for the elderly in the economically underdeveloped western regions.It can be concluded that the elderly in western China have poor living conditions and are more sensitive to the reimbursement rate of medical insurance.After employees retire,the substantial increase in the reimbursement rate makes the relative price of medical services drop,prompting the elderly in western China to make more frequent use of medical services.Fourth,the total medical expenses of retired workers who did not smoke or drink significantly increased by 55.56%;The total medical expenses of the retired workers who smoke or drink are significantly increased by 45.50%.Compared with the elderly who smoke or drink or lack of exercise,the elderly who do not smoke or drink and take part in exercise are more concerned about their own health conditions,properly prevent diseases and do not rely on medical insurance.In addition,the leisure time after retirement is much,old people’s body is a bit unwell with respect to the requirement hospital big work checks,go to a doctor behavior is more frequent,cause excessive medical treatment,appear the circumstance that minor illness is raised greatly.All the above analyses further show that there is moral hazard in the contribution and compensation mechanism of medical insurance to improve the utilization of medical services for the elderly.The conclusion of this paper has certain policy enlightenment significance.The conclusion shows that the contribution and compensation mechanism of medical insurance promote the utilization of medical services for the elderly.Among them,the increase of the total medical expenses is mainly caused by the increase of the proportion of medical expenses compensation.The urban employee medical insurance with higher compensation level not only increases the medical service utilization level of the elderly,but also may aggravate the moral hazard and lead to unreasonable medical consumption.There are income,region and health behavior differences in the influence of medical insurance contribution and compensation mechanism on the utilization of medical services for the elderly.To this end,the government should steadily promote the urban workers and urban residents medical treatment pooling;According to the different medical conditions of the elderly,the implementation of multi-compound medical insurance payment mode;We will make every effort to promote the transition from "treating diseases as the center" to "health as the center" for the elderly.