Study On The Impact Of Urban And Rural Residents’ Serious Illness Insurance On The Incidence Of Catastrophic Medical Expenditure

China’s poverty alleviation campaign in 2021 has come to a successful conclusion,obtaining the historic achievement of eliminating absolute poverty in an all-round way,marking a shift in the focus of poverty alleviation work to the goal of controlling relative poverty to achieve common prosperity.Among the many factors contributing to poverty,disease is one of the most important.Catastrophic medical expenditure is an important measure of the economic risk caused by high medical expenses.When catastrophic medical expenditures occur,people face not only health risks but also heavy financial burdens.At present,there are not a few urban and rural residents with catastrophic medical expenditures.Many people are affected by major diseases and have incurred high medical expenses.Since 1998,the basic medical insurance system consisting of the new rural cooperative medical care,urban residents’ medical insurance and urban workers’ medical insurance has been gradually established and constantly improved.We will work together to protect the medical insurance rights and interests of the majority of insured residents and meet their basic medical needs.In order to further improve the level of medical security,the serious disease insurance system for urban and rural residents was established on the basis of the basic medical insurance system.Serious disease insurance,as an important component of social security,is the extension and extension of basic medical insurance.We should pay attention to the effect of serious illness insurance and whether it can reduce the burden of high medical expenses of residents,so as to alleviate the occurrence of catastrophic medical expenses.In order to further explore the impact of the critical illness insurance system on the incidence of catastrophic medical expenditure for urban and rural residents,this paper mainly discusses the following three questions.Firstly,whether the critical illness insurance significantly alleviates the incidence of catastrophic medical expenditure for residents;Secondly,for residents of different regions and income levels,whether there is heterogeneity in the impact of critical illness insurance on catastrophic medical expenditures;Thirdly,whether the setting of the critical illness insurance starting line will have a significant impact on the incidence of catastrophic medical expenditure.This paper first reviews the domestic and foreign literature on catastrophic medical expenditure,medical insurance,and serious illness insurance system for urban and rural residents.Then it analyzes the current situation of our major disease insurance policy from the perspective of development,main content and operating situation;Further introduces the concept definition involved in this study,and elaborates the relevant theoretical basis;Next,an empirical analysis was conducted based on the panel data of China Health and Pension Tracking Survey(CHARLS)in 2011,2013,2015 and 2018.Firstly,descriptive statistics were used to compare the incidence of catastrophic medical expenditures before and after the implementation of critical illness insurance.Secondly,the Logit two-way fixed effect model was used to study whether the implementation of critical illness insurance for urban and rural residents has a significant impact on the occurrence of catastrophic medical expenditure in the sample.Thirdly,samples with different income levels and different regions were grouped for heterogeneity analysis.In the sample of the implementation of urban and rural residents’ critical illness insurance,this paper studies whether the level of the critical illness insurance threshold will have a significant impact on the incidence of catastrophic medical expenditure.Finally,the robustness test is conducted to verify the reliability of the results.This paper mainly draws the following conclusions: the implementation of the serious illness insurance system for urban and rural residents has played a significant role in alleviating the incidence of catastrophic medical expenditure.The results of heterogeneity analysis showed that,from the regional perspective,the implementation of critical illness insurance for urban and rural residents had a significant impact on the eastern and western regions,and the incidence of catastrophic medical expenditure decreased.Compared with the other two regions,the eastern region had the best policy feedback,while the central region was not significantly affected by the critical illness insurance policy.For different income groups,the implementation of critical illness insurance significantly reduces the incidence of catastrophic medical expenditure in lowincome groups,but the effect on middle and high income groups is not obvious.In addition,the analysis results of the critical illness insurance starting line of urban and rural residents show that the critical illness insurance starting line of urban and rural residents has a significant impact on the incidence of catastrophic medical expenditure,the higher the starting line is set,the higher the incidence of catastrophic medical expenditure.Based on the above research conclusions,this paper puts forward the following four policy suggestions: increase financial subsidies and optimize the financing mechanism;Implement more precise preferential policies for special groups;Adjust the payment standard and expand the coverage of insurance;We will strengthen the connection between serious illness insurance and other medical security systems.