《保险研究》20190309-《商业健康保险是否促进了居民健康——基于微观数据的实证研究》（范红丽、刘素春、陈璐）

［摘   要］党的十九大报告明确提出全面实施“健康中国”战略,强调商业健康保险参与多层次医疗保障体系建设,服务广大人民群众健康保障的重要作用。明确商业健康保险如何从微观层面提高居民健康是有效发挥其助力“健康中国”作用的前提与基础。本文基于中国健康和营养调查(CHNS)2000～2015年面板数据,利用面板工具变量法解决内生性,考察商业健康保险对居民健康水平的影响,同时对不同收入阶层和年龄阶段进行异质性分析,并进行机制探讨。研究表明,商业健康保险能够显著提高居民的健康水平,而且这一正向影响对高收入阶层和中年人群的正向影响更为明显。此外,机制分析表明商业健康保险能够提高居民的医疗服务利用,改善居民健康行为,从而提高健康水平。

［关键词］商业健康保险；居民健康；面板工具变量法

［基金项目］本文获得国家社会科学基金一般项目(编号：16BRK019；16CRK005)、教育部人文社会科学规划青年项目(编号：16YJC630070)和山东省社会科学规划研究项目(编号：18DSHJ04)的资助。本文是“中国特色社会主义经济建设协同创新中心”成果。

［作者简介］范红丽,山东财经大学保险学院副教授,研究方向：医疗保险和健康经济学；刘素春,山东财经大学保险学院教授,研究方向：保险经济学和农业保险；陈璐(通讯作者),南开大学金融学院教授,研究方向：保险经济学和社会保障。

Does Commercial Health Insurance Enhance Public Health？—An Empirical Analysis Based on Chinese Micro-Data

FAN Hong-li,LIU Su-chun,CHEN Lu

Abstract：The 19th CPC Congress Report explicitly put forward the “Healthy China” Strategy,stressing that commercial health insurance should be integrated into the multi-level social healthcare system and play its due role in promoting health status of the general public,and further pointing out that commercial health insurance helping to improve people’s health from the micro plane was the prerequisite and foundation for its playing its due role in the “Healthy China” Strategy.Based on the data from China Health and Nutrition Survey (CHNS) 2000-2015,and using the panel instrumental variable approach (FE-IV) to solve the endogenous problem,this paper examined the effect of commercial health insurance on public health and its mechanism,and conducted a heterogeneity analysis on different income groups and age groups.We found that commercial health insurance significantly improved public health,and the positive impact on the high-income group and middle-aged people were more pronounced.In addition,the mechanism analysis showed that commercial medical insurance improved health service usage,encouraged healthy behaviors,and therefore enhanced public health.The conclusion can provide decision-making reference for further improving China's multi-level social healthcare system.

Key words：commercial health insurance;public health;panel fixed effect-instrumental variable method