The Impact Of Raising The Coordination Level Of Urban Employees’ Basic Medical Insurance On Individual Health

The basic medical insurance for urban employees is an important part of China’s national medical insurance system and is one of the three basic medical insurances(urban employee medical insurance,new rural cooperative medical insurance,and urban residents medical insurance).At the beginning of the establishment of the basic medical insurance system for urban employees,county-level coordination was generally implemented in various regions.This was determined by historical conditions at that time.Compared with higher-level coordination,the county-level coordination of medical insurance fund pools was insufficient and the range of available medical resources was insufficient.The contradiction between the smaller and the increasing public health awareness has become increasingly prominent.In order to alleviate the above-mentioned contradictions,one of the feasible paths has been gradually explored-to improve the overall level of basic medical insurance for urban employees.A higher level of employee medical insurance coordination can more effectively help the insured diversify their health risks,and can alleviate the horizontal unfair use of medical resources between regions,but at the same time,it may also produce work caused by excessive medical care and complicated procedures.Issues such as increased volume and insufficient risk control capabilities under hierarchical operation.In order to test whether improving the overall level of urban employee basic medical insurance improves the individual’s health,whether the individual’s health level and the health equity of individuals in different regions will be significantly improved.This paper is based on the quasi-natural experiment of municipal-level overall planning based on the basic medical insurance for urban employees.It selects the household survey data(URBMI)of the State Council’s Urban Residents’ Basic Medical Insurance Evaluation,matches the municipal macro data,and establishes a dual fixed-effect differential model to evaluate and improve urban employees.The impact of the basic medical insurance overall level on the individual’s health level,and the concentration coefficient(CI)method is used to measure the changes in individual health equity between regions before and after the increase in the overall level.The study found that improving the overall level of urban employee basic medical insurance has a significant effect on the improvement of individual health,and the effect of the improvement has been increasing year by year after the implementation of the policy for one year.Through the analysis of heterogeneity,it is found that the improvement of the overall level of employee medical insurance has a more obvious effect on improving the health of individuals with higher income levels.At the same time,through the calculation of the concentration coefficient method,it is found that the improvement of the overall planning level has not led to the problem of health equity for the disadvantaged groups to subsidize the strong groups,and has also played a role in promoting health equity to varying degrees.This paper further selects income concentration and the opening of high-speed rail as the proxy indicators of regional economic and medical resource distribution to analyze the mechanism,and finds that in areas with higher economic concentration and higher transportation convenience,the improvement of health level is more responsive to the improvement of overall planning.In order to be sensitive,it shows that improving the overall level of urban employees’ basic medical insurance can improve the health of individuals through medical insurance fund adjustments and medical resource sharing.Aiming at the current overall level of basic medical insurance for urban employees in my country,taking the two indicators of health level and health inequity as examples,analyze and demonstrate the impact of the increase in overall level of employee medical insurance on individual health status,and finally put forward targeted countermeasures and suggestions based on the results of empirical analysis This laid a theoretical foundation for the continuous improvement of the overall level of the basic medical insurance for urban employees,and further promoted the sustained and healthy development of the basic medical insurance system.