中国农村医疗保障制度:一项基于异质性个体决策行为的理论研究

摘要

This paper is aimed to provide some responses to the following three hotly debated issues regarding China's new rural cooperative medical system (NCMS),which was launched at the beginning of 2003.Firstly,how many people would join the system voluntarily?Secondly,can the system be self-balanced?And thirdly,would the lump-sum tax benefit the rich more than the poor?Wle build a decision model with heterogeneous agents and we compute the ireplications of NCMS and find under certain conditions.the balanced-system can be sustained and the rate of participation could be higher than 90%.Moreover,it is the unhealthy poor that benefit more from NCMS.%2003年初新型农村医疗保障制度在全国范围内试点,为了回答以下3个问题:(1)这个自愿型的医疗保障体系的参与率有多大?(2)保障体系自身是否可能实现收支平衡?(3)人头税形式的缴费方式是否会使穷人受损而富人获利?根据中国的实际,构建一个异质性个体的消费一医疗支出决策模型,在拟合农村消费-医疗支出行为的基础上计算农村医疗保障制度的福利效应.结果表明,在一定条件下,现行制度可以实现收支平衡,参与率可以达到90%以上,健康状态较差的穷人是最大的受益者.