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The Impact of the Health Insurance System on the Health of the Elderly in Urban China: An Analysis Based on Three-Period Panel Data
By Hongfeng Zhang Hongfeng Zhang Scilit Preprints.org Google Scholar 1, Peng Cheng Peng Cheng Scilit Preprints.org Google Scholar 1 and Lu Huang Lu Huang Scilit Preprints.org Google Scholar 2, *
Received: 19 December 2022 / Revised: 14 February 2023 / Accepted: 17 February 2023 / Published: 21 February 2023
The impact of the health insurance system (MIS) on the health of adults is an important research topic in social security. Because China’s MIS contains different types of insurance, and the benefits and levels of coverage obtained by participating in different health insurances, different health insurances may have different effects on the health of older people. . This has rarely been studied in the past. In this paper, panel data from the third phase of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015 and 2018 were used to examine the effects of participation in social health insurance (SMI) and commercial health insurance (CMI). ) on the health of urban adults and its relation to the process. The study found that SMI had a positive effect on the mental health of adults, but only in the eastern region. CMI participation was positively associated with older adults’ health, but this association was small and observed in a sample of adults aged 75 years and older. In addition, future life safety plays an important role in the process of improving the health of the elderly through health insurance. Both research hypothesis 1 and research 2 were confirmed. The results of this paper show that the evidence of positive effects of health insurance on the health of urban adults proposed by scholars is not convincing. Therefore, the health insurance system should be reformed, focusing not only on insurance, but on increasing the benefits and level of insurance, in order to increase the positive impact on the health of adults.
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Health is a prerequisite for the development of all human beings and is the common aspiration of people all over the world. The 2021 data from the 7th National Census shows that China’s population aged 60 and above is 260 million, an increase of 5.4% compared to the data of the 6th National Census. According to a survey conducted by the Chinese Health and Wellness Commission, the percentage of adults suffering from chronic diseases is about 75%. It follows that the number and health status of older people has changed. In order to reduce the health risks of the elderly caused by diseases, the establishment of a comprehensive health insurance system (MIS) has become an important political challenge for countries around the world. By the end of 2021, the number of people participating in social health insurance (SMI) in China will exceed 1.3 billion, with the participation rate stable at over 95%. The closest level of participation in SMI is universal coverage, which has the effect of reducing the psychological burden of patients and increasing the use of health services [1, 2], is also important for economic and social development [3]. However, the relationship between SMI coverage and health is controversial, with some studies suggesting that SMI participation is beneficial for improving health [4, 5] and others showing that expanding SMI coverage does not necessarily improve health [6, 7].
China has continued to improve the multi-level health insurance system with basic health insurance as the main body, supplemented by various types of supplementary insurance and commercial health insurance (CMI), gradually improving the standard. protection and the ability of commercial insurance services, which provide people with regular health services. The total revenue of CMI fees increased from 2.8 billion yuan in 2000 to 880.36 billion yuan in 2021, an increase of nearly 320 times. This fully shows the importance that the Chinese government attaches to CMI and shows that CMI has great value in meeting the health needs of many levels of people and improving their health. As an important supplement to basic health insurance, CMI can effectively play a role in improving social care and reducing the pressure of medical treatment [8]. CMI has been confirmed by domestic and foreign scholars to reduce the risk of illness in adults and improve the health of the insured group [9, 10, 11].
There are differences between the SMI and CMI groups in terms of insurance benefits, standards and health services [12], which has led to differences in the health of different health insurance groups. Previous studies have explored many factors that influence the health of older adults, but the role of health insurance in older adults’ health lacks sufficient attention, especially the health status of different types of insurance groups. , which did not receive enough attention. This is an important aspect of China’s MIS reform trend that focuses on the promotion of diversity and equity.
Scholars have conducted many analyzes of the impact of MIS on the health of adults, but in many cases, the impact of private health insurance on the health of adults has been studied separately. On the other hand, the health assessment of older adults is mainly based on the ability of daily activities and cognitive ability, and the measurement index is a single one. The health status of adults needs to be fully measured from many aspects. In view of this, this study analyzes the impact of MIS on the health of urban adults based on the China Health and Retirement Longitudinal Study (CHARLS) three-season panel data, and further investigates the differences and mechanisms. forwarding this. influence. Based on this, the small contribution of this paper is mainly reflected in the following three aspects. First, consider the impact of different types of health insurance on the health of urban adults. This paper discusses the health status of urban adults who participate in SMI and CMI, and analyzes how different types of health insurance affect the health status of urban adults, breaking the limitations of existing studies that focus only on insurance. Health. Second, consider the health insurance route. Health insurance can effectively play the role of spiritual security, and participating in health insurance can improve residents’ sense of security and safety in the future. Therefore, this paper analyzes the internal mechanism of future life insurance health insurance that affects the health of urban adults. Thirdly, the effects of demographic characteristics and regional characteristics are considered comprehensively. This paper analyzes the age and regional differences in the impact of health insurance on the health of urban adults, which helps to understand the practical operation of health insurance and the depth of the domestic process of health insurance. By comparing the effects of SMI and CMI on the health of urban adults, it can provide a theoretical basis for improving and improving health insurance policies.
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Health is a state of physical, mental and social well-being. In 1989, the World Health Organization proposed that health is not the absence of disease in the body, but also a state of mental health.
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