The Analysis On Mechanismof Catastrophic Disease Impacting On Poverty And Its Coping Strategies

Health risk is one of the main risks people faced with. People will fall into poverty when the large medical expenses which produced by catastrophic disease impact exceed their ability to pay. That is to say, it is the "poverty due to illness" and "fell back into poverty due to disease". But poverty caused by diseases is not only reflected in the income of the poor, more important in the deprivation of capability. It will reduce the individual ability to earn money to form a vicious spiral between health and poverty and even transfers between generations in serious cases.People usually don’t just choose to bear it passively, but to adopt a variety of risk management strategy to deal with it actively when they face with the catastrophic disease impact. The treatment strategy of risk usually includes preventive strategy, buffer strategy, compensation strategy beforehand and responsive strategy afterwards. In this study, we select the catastrophic disease impact as the research key and the individual suffered catastrophic disease impact as the logical starting point to analyze the health risk ex-post coping strategies based on angle of induction and conduction of health risk. We will get the catastrophic disease impact, welfare consequences-poverty and the formal strategy of health risk into a unified analysis framework. This research mainly along the following three aspects:Firstly, we redefine the concept of major diseases through reviewing the government policy document of major diseases on the basis of the present foreign research results, our basic national conditions and the need of this study. Then we inspect the path from which catastrophic disease impacting the poverty and analyze the impact of catastrophic disease impact on poverty. Thirdly, we select the basic medical insurance system as the formal response mechanism to health risk. Throughing the case study of typical area, we will build the institutional framework of catastrophic disease insurance on the basis of summarizing the practical experience and the theory analysis. Research contents and results specifically stated as follows:Part One:the analysis of catastrophic disease influencing factorsCatastrophic disease affects poverty mainly through the path of the economic burden and the behavior ability. It will not only rise the health spending in short-term, but also affect the behavior ability in long-term. As the formal response mechanism to health risk, the basic medical insurance system remit the economic burden of patient with the catastrophic disease through completing the compensation mechanism. At the same time, it rise the use on medical resources of patient with the catastrophic disease through adjusting the configurationstructure of medical resources to play a role of system type coping strategies to alleviate the effects of poverty because of illness. So this part is mainly to lock the target population of catastrophic disease through the quantitative analysis on catastrophic diseases influencing factors. The analysis will provide theoretical support of our national catastrophic disease insurance system’s construction. The results of quantitative research show that:the situation of catastrophic diseases in general is relatively serious in the group of already having medical expenses. It also shows the obvious "pro-poor" effect. Additionally, the characteristic factors of women, rural residents, chronic disease and low income level will increase the probability of individual suffered catastrophic disease impact.Part Two:the empirical study of impact of major disease on povertyWe have done the quantitative analysis on the catastrophic affecting poverty through the Micro datas of Taicang in this part. The results of quantitative research not only verified the path on economic burden and behavior ability, but also confirmed that the "poverty due to illness"effect is really existence. Thtough using instrumental variables to control the endogenous, we find that the effect of catastrophic disease impact on poverty has been underestimated seriously if we didn’t consider the endogenous problem.Part Three:the coping strategies study of catastrophic disease health riskThis part will mainly analyze the coping strategies of systemtype of catastrophic disease health risk. The construction of our national basic medical insurance system is not only changing from division of urban and rural and model of fragmentation to balance urban and rural development and model of unification. The security key is also changing from "ensure basic and cover broadly" to catastrophic disease which causes the heavy economic burden of urban and rural residents. It provided a macro background support of the case study. In this paper, we select the representative and the typicalTaicang area as object of our case study. The results of case study show that: the catastrophic disease insurance system achieved good operating results as a whole. The catastrophic disease economic burden of urban and rural residents has got obvious reliefduring the period of system operation for two years. Through establishing and perfecting the medical insurance regulatory system, the momentum of rapidly rising medical costs to get a good control. Additionally, catastrophic disease insurance system has reconfigured the medical resources between urban and rural areas and different income groups. It also made on the whole health care system further leaning to disadvantaged groups and closed the gap of security level between the groups of catastrophic disease. So it improved the fairness of medical insurance system. On the basis of case study and theory analysis, we built the institutional framework of catastrophic disease insurance system respectively from the aspects of the system constructionprinciple, the financing mechanisms, the compensation mechanism, the operation mechanism and the regulatory mechanisms.