工作论文
当前位置:首页 > 工作论文
我国公共健康支出受益归宿及其收入分配效应——基于医疗服务入户调查数据的微观证据
阅读全文         下载全文
TitleBenefit Incidence of Public Spending on Healthcare and Its effects on income distribution  
作者李永友 郑春荣  
AuthorLi Yongyou and Zheng Chunrong  
作者单位浙江财经大学;上海财经大学 
OrganizationZhejiang University Of Finance & Economics; Shanghai University of Finance and Economics 
作者Emailliyy@zufe.edu.cn;zhchr_1975@163.com 
中文关键词公共健康支出;医疗服务;受益归宿;分配效应 
Key WordsPublic Spending on Healthcare; Medical Service; Benefit Incidence; Distribution Effects 
内容提要公共健康支出能否成为消除不同收入群体健康不平等,矫正社会现金收入分配差距重要手段,关键取决于谁从公共健康服务中受益。本文基于CFPS入户调查数据,利用保险价值法,对2009年中国新医改前后公共医疗支出受益归宿进行分析。结论表明,中国新医改通过扩大医疗保险覆盖面和提高医疗服务可及性与财政补助水平,不仅提高了公共医疗支出受益分配累进性,而且实现了一定程度的正义性,使最穷收入分组家庭成为新医改最主要受益群体。公共医疗支出受益正义分配使中国家庭间收入分配基尼系数下降了5到7个百分点。然而,新医改之后,中国公共医疗支出受益再分配存在两个明显问题:一是严重偏向最穷收入分组家庭的公共医疗服务成本分担显著降低了公共医疗支出收入再分配效应,使中国家庭间收入分配基尼系数上升2到3个百分点;二是尽管新医改一定程度上实现了偏向最穷收入分组家庭的公共医疗支出受益分配,但其产生的再分配效应不是发生在最穷与最富两个收入分组家庭之间,而是发生于前80%收入分组家庭内部,后者造成中间60%收入分组家庭从公共医疗服务中所获受益不仅没有因为新医改而得到提高,反而在新医改之后出现明显下降,其受益份额由2008年的55%下降到2010年和2012年的不足30%。 
AbstractWhether is public spending on healthcare an important way to eliminate health inequalities among different income groups and social distribution gap of cash income, which depends on who can benefit from the public health service. Based on CFPS and insurance value method, this text analyzed benefit incidence of public spending on healthcare after and before China's new medical reform in 2009. Results show that China's new medical reform not only improved the progressive of benefit allocation of public spending on healthcare and achieved a certain degree of justice by expanding health insurance coverage and improving the level of financial assistance, which made the poorest income families to become the main beneficiaries. The justice distribution of benefit allocation of public spending on healthcare reduced the Gini coefficient by 5 to 7 percentage points. However, after the new medical reform, benefit redistribution of public spending on healthcare has two obvious problems: one is the serious bias of public medical service cost towards the poorest income families, which significantly reduced the income redistribution effects of public spending on healthcare, leading to the Gini coefficient of income distribution rising by 2 to 3 percentage points; the other is although the new medical reform made the benefit distribution of public spending on healthcare skew towards the poorest income families, the redistribution effect does not occur between the poorest and the richest families, but within the top 80% income groups, which caused the benefit share of 60% middle income families from public health services to decrease from 55% in 2008 to less than 30% in 2010 and 2012. 
文章编号WP1106 
登载时间2016-08-30 
  • 主管单位:中国社会科学院     主办单位:中国社会科学院经济研究所
  • 经济研究杂志社版权所有 未经允许 不得转载     京ICP备10211437号
  • 本网所登载文章仅代表作者观点 不代表本网观点或意见 常年法律顾问:陆康(重光律师事务所)
  • 国际标准刊号 ISSN 0577-9154      国内统一刊号 CN11-1081/F       国内邮发代号 2-251        国外代号 M16
  • 地址:北京市西城区阜外月坛北小街2号   100836
  • 电话/传真:010-68034153
  • 本刊微信公众号:erj_weixin