Research On The Impact Of Commercial Health Insurance On Household Catastrophic Health Expenditures

Under the background of the increasingly prominent problem of disease economic risk,our country’s basic medical insurance currently has the characteristics of wide coverage,insufficient protection and a high proportion of personal medical expenses.The problem of the heavy burden of medical spending still remains.In the "Administrative Measures for Health Insurance" issued by the China Banking and Insurance Regulatory Commission in 2019,commercial health insurance is positioned as an important part of the multi-level medical security system.At the same time,under the influence of the Corona Virus Disease epidemic,residents have paid more attention to personal health issues,and commercial health insurance has gradually been favored by more residents,which can help families prevent poverty due to illness and return to poverty due to illness better.In the field of international health economics,a concept similar to but different from poverty due to illness has gradually attracted attention.It also emphasizes the impact of illness on households,namely the catastrophic health expenditure,based on this indicator,can describe our country’s national conditions of poverty due to illness better.So,as an effective supplement to the medical security system,can commercial health insurance effectively reduce the catastrophic health expenditure of families? Therefore,it is necessary to conduct in-depth research and analysis on this issue.Based on the analysis of the development of commercial health insurance,this paper uses the ROC curve and the Youden index method to analyze the data of the2019 China Household Finance Survey,and proposes a definition standard for household catastrophic health expenditures that is suitable for our country’s actual standards.Then,by constructing a Logit model,to empirically study the impact of commercial health insurance on household catastrophic health expenditures.The propensity score matching method is used for endogenous test.After robustness test and heterogeneity analysis,the research conclusion of this paper is drawn.The study found that:(1)Using family medical expenses/affordability,family medical expenses/total income,and family medical expenses/disposable expenses as indicators,the optimal definition standards for catastrophic health expenditures were calculated as 11%,9%,17%.(2)On the whole,the incidence of catastrophic health expenditures of households with commercial health insurance was significantly reduced by 4.5%,and the conclusion was still valid after endogenous and robustness tests.(3)Different ages,incomes,and urban-rural gaps have different effects on commercial health insurance in reducing the incidence of catastrophic health expenditures.From the perspective of age,the mitigation effect on the elderly is greater;from the income factor,the mitigation effect on the lower-income population is greater;from the urban and rural factors,the mitigation effect on the rural population is greater.Combined with the research conclusions,this paper puts forward some suggestions to accurately identify vulnerable people who are easy to return to poverty,promote the effective connection between basic medical insurance and commercial health insurance,strengthen the operation and management of insurance institutions and improve consumers’ own health awareness,in order to further improve the fairness of China’s multi-level medical security system.