The Effect Of Income Redistribution In Medical Insurance ——A Case Analysis Of Employee Basic Medical Insurance In Shandong Province

China has entered a new stage of development,where everything is done to promote common prosperity,but there are still problems of unbalanced and insufficient development,especially between urban and rural areas and between income distribution gaps.As one of the tools to directly regulate the distribution and redistribution of national income,basic medical insurance assumes an important responsibility and mission.This paper explores the income redistribution effect of medical insurance by taking the basic medical insurance for urban workers in Shandong Province as an example.Using the collected data of employee basic medical insurance in Shandong Province in2018,this paper explores the income redistribution effect of employee basic medical insurance by calculating the Gini coefficient and the MT index,taking the income after contributions and different levels of compensation of employee basic medical insurance as the research object.On this basis,the Gini coefficient is decomposed to explore the contribution of inter-system fairness and intra-system fairness to overall fairness and further analyze whether the existence of individual accounts and individual account balances have an impact on the medical treatment choices of the insured groups.The main conclusions of this paper are as follows: first,employee basic medical insurance can alleviate the current situation of income inequality in society to a certain extent after stripping health inequality factors,but it has never bridged the income gap brought by health and medical service utilization,and still shows a reverse redistribution effect overall;second,the multi-level compensation design of employee basic medical insurance has different effects on income redistribution.The pooling account of basic medical insurance has a significant positive income redistribution effect,the supplementary security such as medical subsidy and enterprise supplement has a slight reverse redistribution effect,and the personal account compensation has a large reverse redistribution effect;third,the fragmented system characteristics of employee basic medical insurance result in heterogeneity of its income redistribution effect in terms of region,population,type of consultation,type of cost and special compensation;fourth,individual accounts further hinder the income redistribution effect of employee basic medical insurance,and the balance of individual accounts has an inducement effect on employees’ choice of hospitalization.The results of this paper show that although the employee basic medical insurance plays an important role in compensating for the income loss suffered by health shocks,the income redistribution effect of the employee basic medical insurance is still reversed due to the serious fragmentation of the system,the small number of people covered at some levels and the individual accounts,and there is still room for improvement of the basic employee health insurance.In the future,it is necessary to continuously improve the system design on this basis.Finally,this paper puts forward the following suggestions: first,further improve the level of protection and efficiency on the basis of full coverage;second,continue to improve the multi-level compensation mechanism to achieve precise protection;third,improve the level of coordination of employee basic medical insurance,promote provincial coordination and gradually realize national coordination;fourth,promote the reform of individual accounts and improve the basic medical insurance outpatient co-payment protection mechanism.The implementation of employee basic medical insurance will ease the pressure of medical treatment,enhance the fairness between groups while curing the illnesses of the masses,and further promote social equity to achieve the beautiful vision of medical insurance and common prosperity.