Research On The Poverty Alleviation Effect Of Critical Illness Insurance For Urban And Rural Residents In Hubei Province

In recent years,China has intensified its efforts to eradicate poverty,but poverty,especially rural poverty,is still prevalent,with the proportion of disease-causing poverty and disease-returning to poverty increasing.Data from the national survey of 89.62 million poor people in 2013 shows that the proportion of disease-induced poverty is as high as 42%,which is at the forefront of all poverty-causing factors.By the end of 2015,the poverty stricken population had decreased by more than 20 million,but the proportion of disease-causing poverty and disease-returning to poverty had risen to 44.1%.In 2017,there were still 30.46 million people living in poverty in China's rural areas,with an incidence of poverty of 3.1 percent.In the construction of China's social governance system and governance capacity,under the guidance of scientific theory and the cooperation between government and market through the PPP model,it is of great theoretical and practical significance to reform and innovate the medical security system of China's critical Illness and to establish a long-term mechanism of health poverty alleviation in order to effectively solve the problem of poverty and improve the social security system.Critical Illness Insurance(CII)is a supplement and improvement of the basic medical insurance system.It is an institutional combination of social insurance,commercial insurance and targeted poverty alleviation.It is an important measure to solve the problem of "Poverty due to critical illness,or returning to poverty due to critical illness".The Party Central Committee and the State Council have attached great importance to the work of poverty alleviation and poverty alleviation.They have repeatedly emphasized the importance and urgency of implementing health and poverty alleviation and vigorously developing CII,also have launched pilot projects for CII throughout the country.Hubei Province launched a comprehensive implementation of CII.Critical Illness Insurance System(CIIS)covers all the urban residents participated in social medical insurance and rural residents participated in new rural cooperative medical care system since 2013.How to evaluate the poverty alleviation effect of CII in Hubei?How to evaluate the current conditions for the prevention of poverty alleviation by CII?Based on the related theories such as Public Goods Theory,Social Security Theory,Health Economics Theory,Disease Risk Theory and Poverty,this paper uses literature analysis,comparative analysis and GMM estimation methods to conduct qualitative and quantitative research.This research examine the fairness,efficiency and sustainability of CIIS for urban and rural residents in Hubei Province,analyse the impact of CII on the rational use of medical resources by urban and rural residents and the effect of poverty alleviation.This research provides a sound empirical experiencebasis for improving the CIIS of Hubei Province and maximizing the function of poverty alleviation effect of CII.This paper is divided into six parts.Introduction section.This paper mainly introduces the research background,research questions and research topics,puts forward the research objectives and main contents of this paper,defines the important concepts in this paper,designs the research methods and technical routes,points out the innovation of this paper,as well as the shortcomings of the paper and the future research prospects.Chapter one is literature review and theoretical analysis.Mainly based on the existing domestic and foreign literature on CII and poverty,this research uses Public Goods Theory,Social Security Theory,Health Economics Theory,Disease Risk Theory,Poverty Theory and other related theories,to carry out the Poverty Alleviation Effect theory of CII,to construct the theoretical analysis framework of the Poverty Alleviation Effect of the CIIS in Hubei province.The second chapter is about the analysis of the poverty situation of urban and rural residents in Hubei Province and the CIIS.Based on the previous theoretical analysis,and according to the income per capita,consumption per capita and the poverty rate of urban and rural residents in Hubei Province,this chapter analyses the poverty situation of urban and rural residents in Hubei Province by using comparative analysis method and data statistics method.It systematically summarizes the related policy contents,operating mechanism and mode characteristics of the CII in Hubei Province.Through the chart data,this paper investigates the degree of insurance coverage,premium income,compensation,protection effect and supervision,and describes the overall development of Hubei Province since the implementation of the CII.The third chapter is about the guarantee condition of the CII effect for urban and rural residents in Hubei Province.This chapter mainly constructs the effect evaluation index system from three aspects of equity,efficiency and sustainable development,and evaluates the institutional guarantee effectiveness of the poverty alleviation effect of CII in Hubei Province.The fairness guarantee of the poverty alleviation effect of urban and rural residents in Hubei Province is quantitatively assessed from the aspects of the overall level,the rights and obligations.The efficiency guarantee of the poverty alleviation effect of urban and rural residents in Hubei Province is quantitatively assessed from three aspects of management level,beneficiary groups and management costs.By constructing financing model,cost compensation model and accumulative balance model,this paper predicts the balance of the urban and rural residents' major sickness insurance in Hubei Province,and evaluates the sustainability guarantee of the poverty alleviation effect of the CII.The fourth chapter is the empirical analysis of the effect of the CII for urban and rural residents in Hubei Province.In this chapter,based on the evaluation of the institutional guarantee effectiveness of the poverty alleviation effect of the urban and rural residents in Hubei Province,the paper mainly takes the personal data of the 2014-2017 disease insurance compensation as the base period,and uses the generalized moment estimation(GMM)panel data,to empirically analyses the influence of urban and rural residents 'major sickness insurance on the decision-making of health care expenditure and poverty-alleviation effectiveness.The empirical results show that the implementation of CII increases the medical expenses of urban and rural residents,significantly reduces the tangible and intangible economic burden brought by critical diseases to residents,and has a poverty alleviation effect on both urban and rural residents,and has a greater impact on rural residents.The fifth chapter is the countermeasures and suggestions to promote the development of the CII for urban and rural residents in Hubei Province.On the basis of the previous qualitative and quantitative researches,this chapter makes a further analysis and summary of the main research conclusions,and proposes that the reform of the CIIS should be deepened if the CII in Hubei Province is to fully exert its poverty alleviation effect.Increase income and reduce expenditure to ensure the sustainability of the CIIS.It will be better to appropriately tilt the balance toward rural areas and narrow the medical gap between urban and rural areas.This paper holds that critical illness insurance for urban and rural residents can reduces significantly their tangible and intangible economic burden,which in turn promotes the effect of poverty alleviation,and the impact mechanism of rural residents is greater than that of urban residents.The empirical results echo the theory of disease and poverty in Chapter 1.Critical illness cause patients and even entire families to fall into poverty by increasing the patient's tangible and intangible medical burden.Nevertheless,CIIS has improved the initiative of residents for medical treatment,which can contribute to the increase of the probability of rehabilitation,and improve the behavioral capacity of residents.On the other hand,the reimbursement in proportion for compliant medical expenses has reduced the burden of residents' final medical expenses.Therefore,the critical illness insurance has exerted the effect of poverty alleviation through the above-mentioned influence mechanism.However,from the perspective of the investment in urban and rural residents in Hubei Province,the security of rural areasstill needs to improve.Compared with the existing research literature,this paper is innovative in three aspects:Firstly,it created the micro-research perspective of "Targeted poverty alleviation" for major illness insurance.The existing literature on health poverty alleviation,especially the CII for poverty alleviation,is not systematic and perfect.The research on CII is limited to the macro level analysis of the balance of the big illness insurance fund.This paper takes micro-individual as the research object,from the perspective of health risk,and evaluates and improves the poverty alleviation effect of Hubei Province's major illness insurance from the perspective of new micro-investigation.It includes "disease due to illness","critical illness insurance" and"Targeted poverty alleviation" into a unified theoretical analysis framework,and proposes policy recommendations based on empirical results.Secondly,the theoretical analysis system for poverty alleviation of CII was established.Based on the Public Goods Theory,Social Security Theory,Health Economics Theory,Disease Risk Theory and Poverty Theory,this paper puts forward the theoretical hypothesis that CII can help urban and rural residents get rid of poverty,and quantitatively analyses the effect and mechanism of CII for reducing poverty and returning to poverty due to the incapacity of work.Thirdly,the GMM estimation method is used to empirically analyse the poverty alleviation effect of CII.In the relevant literature,there is little empirical analysis of the poverty alleviation effect of CII.Based on the collected micro-individual data,this paper divides the sample data into urban and rural areas,and empirically compares the urban-rural differences in the effect of poverty alleviation.At the same time,in order to overcome the biased influence of endogenous and short panel data on the empirical results,this paper uses GMM estimation method to regress the sample data and do related robustness test.The quantitative empirical regression results in this paper provide a sound empirical experience basis for improving the CII in Hubei Province and maximizing the function of poverty alleviation for CII.The deficiencies of this paper are as follows:on the one hand,the research needs to be expanded.Since Hubei Province's critical illness insurance system is covered in urban and rural area until 2013,the operational model and key concepts of critical illness insurance are still in the process of exploration.Although this paper analyses the current situation of the major illness insurance system in Hubei Province and quantitatively analyses its impact on poverty,with the further improvement and adjustment of the major illness insurance system in Hubei Province,it is still necessary to continue to study this topic.I will continue to study the poverty alleviation effect of CII for urban and rural residents in Hubei Province,and focus on the mechanism of poverty alleviation effect of CII from the theory and quantitative,that is,how the poverty alleviation effect is generated.on the other hand,the sample data collected should be improved.Since there is no officially publicly disclosed data of the whole province required for the study,this paper only collects the critical illness insurance of urban and rural residents in Xiang-Yang City.Under the conditions of continuous improvement of official public disclosure data,I will collect comprehensive,detailed,reliable and long-term panel data,and thoroughly compare the differences in the poverty alleviation effects of different insurance in China's CIIS.The evaluation index system and quantitative analysis method of the CIIS in this paper also will be improved.