Policy Cognitive Ability And Adverse Selection Of Insurance Participation

Continuously improving the basic medical insurance protection mechanism,implementing the basic medical insurance participation and payment policy,and promoting the high-quality development of the basic medical insurance system are the fundamental requirements for the construction of a healthy China.The results of the seventh national census showed that rural elderly people aged 60 and above accounted for 23.81% of the total rural population,indicating that as a large number of rural elderly people,their social welfare should receive sufficient attention.For a long time,the centralized collection of National Basic Medical Insurance has always been the focus of the grassroots government’s annual work.In academia,whether individual residents choose to participate in the government-led social insurance system,especially what factors will drive residents to make adverse selection behavior,has always been an important research topic.Existing studies generally describe the impact of National Basic Medical Insurance system defects on the insured’s choice of insurance from the system level,but pay less attention to the insured’s perception of the insured as a rational agent and the possible impact on the cognitive outcome of the policy.This thesis proposes that as social insurance is an important social policy,residents’ cognitive ability will shape their cognition of the policy and significantly affect residents’ participation in insurance.Based on the 2018 data from the China Health and Retirement Longitudinal Study(CHARLS)and Urban and Rural Resident Basic Medical Insurance,this thesis explores the impact of rural elderly’s policy cognitive ability on their medical insurance participation behavior.The results show that:(1)the policy cognitive ability of the rural elderly will positively affect the occurrence of adverse selection;(2)social communication,family support,and health habits of rural elderly can adjust the correlation between the policy cognitive ability and adverse selection: when the rural elderly have less social communication,more family support and unhealthy habits,there is a significant correlation between policy understanding ability and adverse selection,however,there is no significant correlation between policy cognitive ability and adverse selection behavior when the rural elderly have more social communication,less family support and healthy habits.Subsequently,the thesis divided the research samples into three types: Eastern,Central,and Western regions,and tested the specific conditions shown by the samples in each region in a targeted manner,and found that rural elderly people in different regions will be affected by different factors when choosing insurance.Adjustments have their own priorities.Among which,care from children can reduce the negative effect of rural elderly policy awareness in the eastern region on the participation of urban and rural residents in National Basic Medical Insurance.For the rural elderly in the central region,spouse care and offspring economic support alleviate the negative effects of policy cognitive ability on the participation of National Basic Medical Insurance Program for urban and rural residents.For the rural elderly in the western region,their basic economic conditions may become the most important adjustment factor.According to the empirical results,the thesis proposes that the government should continue to promote the National Basic Medical Insurance policy to improve the efficiency of system management,pay attention to the social interactions of the rural elderly and the care of the elderly,and help consolidate the network relationship in the village,or appropriately force some of the urban and rural residents to participate in the National Basic Medical Insurance Program for urban and rural residents.