The Impact Of The Basic Medical Insurance For Urban And Rural Residents On The Consumption Inequality Of Rural Residents

The basic medical insurance for urban workers,the new rural cooperative medical insurance and the basic medical insurance for urban residents constitute China’s basic medical security system.Rural residents and urban residents are covered by two basic medical insurance,which has gradually produced some negative effects,such as uneven medical resources,duplicate participation and obvious differences in medical security welfare.Therefore,in January 2016,the State Council issued the Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents,which merged two basic medical insurance for urban and rural residents.It asks to establish a unified basic medical insurance for both urban and rural residents,making our country’s medical security system more equitable."Common prosperity" is one of the key words of policy in the field of social and people’s livelihood.It’s suported by statistics that the per capita consumption expenditure ratio of urban and rural residents remained above 1.9 from 2013 to 2021,although it showed a downward trend.The consumption gap between urban and rural residents in China has always existed.How to alleviate the consumption inequality of rural residents,a relatively vulnerable group,and improve their living welfare has become one of the concerns to achieve high-quality development.The integrated basic medical insurance for urban and rural residents is beneficial to enhancing the people’s well-being,as one of the reform results of improving the social security system in our country,which breaks the original design of separate basic medical insurance for urban and rural residents.From the perspective of rural residents,by calculating the consumption relative deprivation index to quantify the consumption inequality between individuals,and analyzing the impact of basic medical insurance for urban and rural residents on consumption inequality,it not only enriches the research on the impact of social security on the relative level of consumption,but also helps to analyze part of the economic performance of urban and rural coordination of medical insurance from a realistic perspective,so as to put forward relevant suggestions for improving the social medical security system and narrowing the consumption gap.Based on the research hypothesis and theoretical analysis,this paper uses CHFS data of 2017 and 2019,delineates rural samples,adopts a fixed-effect model,and introduces control variables,time and city fixed effects for benchmark regression.The robustness of the conclusions was tested by substituting explained variable,explanatory variables and quantile regression methods.Propensity score matching and instrumental variable were used to analyze possible endogeneity problem;then heterogeneity and mechanism of influence were analyzed.The empirical results show that:(1)The consumption inequality of rural residents is alleviated by participation of the basic medical insurance for urban and rural residents;(2)The robustness test considered the possible adverse selection and moral hazard problems in insurance participation,the information loss of household participation variable identified by household head participation,and the difference in results at different quantile points,and the conclusion was still valid;(3)The endogenous problems that may be caused by omission bias,sample self-selection and two-way causation were analyzed,and the results were basically consistent with the basic regression;(4)After heterogeneity analysis,the effect of basic medical insurance for urban and rural residents on the consumption inequality of rural residents is relatively strong in the young,health risk struck,without self-owned housing and households with lower income.The increase in medical benefits brought by the basic medical insurance for urban and rural residents after the integration better guarantees the consumption welfare of more vulnerable groups in rural households;(5)According to the analysis of the mechanism of influence,the alleviation effect of basic medical insurance for urban and rural residents on consumption inequality has an impact on stimulating non-medical consumption,releasing preventive savings and narrowing income inequality.Policy suggestions on improving China’s social security system and alleviating consumption inequality can be put forward from the perspectives of policy support,group dimension differences and the above influence channels,which is conducive to promoting social fairness and justice and protecting people’s livelihood rights and interests in the pursuit of high-quality development of our country’s economy,in the basis of the empirical results,The possible innovation of this paper lies in the following:(1)From the perspective of individual relative deprivation index,the relative deprivation index of household consumption is calculated to measure the consumption inequality from a micro perspective;(2)Different from the absolute value of consumption,the impact of basic medical insurance for urban and rural residents on the relative level of consumption was analyzed;(3)Focus on rural residents,a relatively vulnerable group,and analyze the impact of the improvement of the medical insurance system on consumption welfare.