The Impact Of The Serious Illness Insurance System On Urban And Rural Residents On The Health Level Of Rural Residents

At present,China has achieved the first centennial goal of building a moderately prosperous society in an all-round way,the people’s living standards have been comprehensively improved,the people’s pursuit of their own health has gradually improved,and the demand for health security has also increased day by day.As a large agricultural country with a large rural population,health protection is more important for rural residents who are mainly engaged in manual labor.However,due to the principle of "guaranteeing the basics",the two systems of basic medical insurance for urban residents and new rural cooperative medical care in China are insufficient to resist the risk of serious diseases.To this end,in August2012,six ministries and commissions,including the National Development and Reform Commission,the Ministry of Health,and the Ministry of Human Resources and Social Security,jointly issued the Guiding Opinions on Carrying out Critical Illness Insurance for Urban and Rural Residents,which clearly establishes a serious illness insurance system on the basis of basic medical insurance protection.Urban and rural residents’ serious illness insurance is China’s unique medical insurance system,and China has issued a series of policy documents to promote and standardize the development of serious illness insurance.The purpose of the implementation of the serious illness insurance system is to further protect the high medical expenses incurred by residents suffering from serious diseases,alleviate the problem of poverty caused by illness and return to poverty due to illness,prevent residents from experiencing expenditure-based poverty,improve the health level of residents,and make up for the lack of basic medical insurance for serious diseases.Since its introduction,the serious illness insurance system has developed rapidly,and basically achieved full coverage in 2016.A large number of studies have demonstrated the relationship between the new agricultural cooperative and the health of rural residents,but there are few studies on the health effects of serious illness insurance policies for urban and rural residents,especially on the health level of rural residents.However,China’s current medical and health system has various difficulties,and the limited medical resources have prompted us to think deeply about related research topics such as the effect of serious illness insurance policies.Therefore,it is necessary to analyze the impact of the serious illness insurance policy on the health level of rural residents after the implementation of the serious illness insurance policy.The five data of China Household Tracking Survey(CFPS)from 2010 to 2018 were selected and analyzed using Stata statistical analysis software.Firstly,the five periods of data from 2010 to 2018 were converted into balanced panel data according to individual code(PID)and year,and two explanatory variables,as well as core control variables and provincial characteristic variables,were selected to establish a double difference model to judge the net effect of policy.Secondly,in order to ensure the robustness of the research results,the five-phase panel data were used to conduct parallel trend tests and PSM-DID tests for the two explanatory variables of self-rated health and others’ evaluated health.Finally,the mediating effect is used to analyze the health utility of serious illness insurance policy,and the sample is further divided according to population characteristics such as age,income and region,so as to explore the heterogeneity of policy implementation on the health level of different populations.The results found that:(1)the implementation of the serious illness insurance policy for urban and rural residents had a significant positive effect on the improvement of rural residents’ self-rated health and others’ evaluation;(2)The implementation of the serious illness insurance policy for urban and rural residents has significantly increased the hospitalization expenses of rural residents and improved the utilization of medical services.The results of mechanism analysis further show that the serious illness insurance policy plays a role in improving the health level of rural residents by improving the utilization of inpatient medical services.(3)After the analysis and study of population heterogeneity,it was found that the implementation of the serious illness insurance policy for urban and rural residents was statistically more significant in improving the health level of middle-aged and elderly groups,low-and middle-income groups and residents in central and western regions.