摘要
我国在制度层面已建成多层次、全覆盖的医疗保险体系。然而,随着互联网经济的不断发展,自雇群体的分化与发展导致其医疗保险的参保决策区别于普通民众。研究发现,自雇者参保形式多样,但未享有任何形式医疗保险的比例不在少数。过去两周是否生病、收入水平和主观阶层地位对自雇者参保决策有显著的影响。相比之下,医疗保险制度分割性的影响效应更强。值得注意的是,非体力自雇者的参保决策更多遵循理性选择的逻辑,制度因素则是制约体力自雇者行为选择的重要因素。因此,以底线公平为基础,辅以效率原则,优化整合基本医疗保险制度是政策变革的发展方向。
China has built a multi-level and universal coverage medical insurance system.However,with the development of Internet economy,the differentiation and expansion of self-employed lead to different decision-making of medical insurance.It is found that the forms of insurance purchase varies,but some of them have not any type of medical insurance.The prevalence of illness over the past two weeks,income levels and subjective class status has significant impact on decisions-making of medical insurance.By contrast,the effect of segmentation of medical insurance system is stronger.It is worth noting that the decision for non-manual self-employed follows the logic of rational choice,and the institutional factor plays an important role in the behavior of manual self-employed.Thereby,the integration and development of medical insurance system should be based on fairness and supplemented by the principle of efficiency.
作者
黄嘉文
邓宝欣
HUANG Jia-wen;DENG Bao-xin(School of Public Administration,South China University of Technology,Guangzhou Guangdong 510640,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2018年第9期1-7,共7页
Chinese Journal of Health Policy
基金
国家社会科学基金重大项目(12&ZD095)
国家自然科学基金面上项目(71472066)
广东省哲学社会科学规划项目(GD17YSH02)
关键词
医疗保险
参保决策
理性选择
制度分割
自雇者
Medical insurance
Insurance decision-making
Rational choice
Institutional segmentation
Selfemployed
