Analysis Of The Selection Of Raising The Health Insurance To Provincial Level In China

China have established a basic medical insurance system for urban employee,the new rural cooperative medical system and basic medical insurance system for urban residents since 1998,but to date,the three major social medical insurance systems have been at a lower overall level.As the degree of the market and urbanization increased,mobility of labor and the population increasing,the inconsistent contradiction between insured hospital for medical treatment and the location of medical insurance relationship has become increasingly prominent.After the transition from county level to municipal level,whether we have to enhance the medical insurance of employee to the provincial level?This is the question that the theory and practice of social health insurance need to answer.Throughout the discussion of the relevant domestic and foreign literature about the level of medical insurance,they have the support of increasing and the opposition of increasing.But whether it is the support or opposition,their opinions are just theoretical description with a general lack of scientific theoretical framework and specific quantitative analysis.This paper uses China's basic medical insurance for urban workers as the research object,and tries to answer whether the overall level of medical insurance should be improved from the municipal level to the provincial level by quantitative analysis.First,this paper analyzes the moral hazard and fund anti-risk capability,then separately analyzes the their relation with overall level and build analytical framework of enhancing the overall level of health insurance.Secondly,according to the proposed analytical framework,it uses the practice data of the transition of the basic medical insurance for urban employee from the county level to municipal level in 2011,and uses Blinder-Oaxaca decomposition method to decompose the difference between medical expenses of the county level and municipal level,and analyzes the moral hazard by the unexplained different part.Then it uses the "medical insurance fund reserve ratio" to represent the fund's anti-risk capability and analyzes changes of anti-risk capability brought by provincial level and municipal level of Jiangsu province.Finally,it compares the loss of the moral hazard caused by the overall level and the benefit brought by the increasing of fund anti-risk ability,and results in whether we should enhance the overall level.The results show that,the transition from county to municipal overall level consists of 66.1%explained part of the difference between their the medical expenses,and the 33.9%unexplained portion,and results that medical insurance pool fund of Jiangsu province losses(increase in expenditure)3.365 billion RMB.With the transition from the municipal to the provincial level in Jiangsu,the medical insurance fund reserve ratio increased from 0.85 years to 0.91 years,the positive benefit caused by the strength of anti-risk ability is 2.977 billion RMB,Because the loss of the increased moral hazard is much larger than the benefit brought by the increasing of fund anti-risk ability,the medical insurance of Jiangsu Province urban employee should not be enhanced to the provincial level.Although conclude that medical insurance should not be enhanced to the provincial level,it must be pointed that this is only for the analysis of Jiangsu province.Due to the differences of provincial health insurances and socio-economic environments,the conclusions of the provinces should be achieved after the analysis of each province.