Research On The Influence Of Medical And Health Expenditure On Labor Supply Of Middle-aged And Elderly In China

According to relevant public data,the average life expectancy in China was77.47 years in 2019 and is expected to rise to 82.28 years in 2050,an increase of 4.81 years.With the aging of the population becoming more and more serious,the fertility rate is gradually decreasing.Although the country is currently open to the three-child policy,the improvement level of fertility rate and the short-term supply of labor force are affected by lag effect and other factors.Declining birth rates and longer life expectancy have led to a shortage of workers and an aging population.At the same time,longer life expectancy will lead to lower birth rates,higher health spending and lower productivity per worker.In this context,China’s demographic dividend is gradually declining,so it is of great significance to study the factors affecting the labor supply of the middle-aged and elderly,which can provide theoretical support for the development of human capital of the middle-aged and elderly and active pension.The labor supply of the middle-aged and the elderly has a lot to do with the medical and health cost.When the government medical and health cost of the residents increases,the health level of the residents improves,and with relatively rich working experience and skills,the labor supply can be extended to alleviate the problem of market shortage.This paper firstly summarizes recent literature and analyzes the current situation of medical and health cost and health human capital in China.Then combined with the recent economic theory,the mechanism of the impact of medical and health expenditure and health human capital on the labor supply of middle-aged and old people is analyzed,and it is believed that human capital can affect the labor supply decision of middle-aged and old people.Empirically,this paper uses the data of the newly released 2018 China Health and Old-age Care Tracking Survey(CHARLS),uses Probit model and OLS model to study the influence of medical and health expenditure and health human capital on labor participation and labor duration of middle-aged and elderly respectively,and conducts mediating effect test,heterogeneity analysis and robustness analysis.The medical and health expenditure in2017,which was one year behind,was also selected as an instrumental variable of medical and health expenditure to deal with endogeneity.The results show that the working hours of middle-aged and old people will increase with the increase of medical expenditure.In terms of the types of medical expenditure,the increase of government medical and health expenditure is not conducive to the increase of labor participation and working hours of middle-aged and elderly,while the increase of social medical and health expenditure will increase the labor participation and working hours of middle-aged and elderly.The mediating effect of health human capital on labor participation and working hours is positive and significant.The results of 45 to 60 years old,60 to 70 years old,rural areas and families with middle and high income and above are consistent with the results of the total sample.Medical and health expenditure has a positive impact on the labor participation and working time of the middle and old people;By gender,the labor supply of health care expenditure is more significant for men after retirement and for women before retirement.Finally,another regression model,Logit model and Tobit model,was used for the regression of the whole sample,and the results were consistent with the previous results.The marginal effects of medical and health expenditure and health human capital on labor participation and labor hours of middle-aged and elderly were significantly positive,indicating that the empirical results were relatively robust.From what has been discussed above,this paper puts forward policy suggestions from the level and efficiency of medical and health expenditure,flexible retirement system and active pension.We should improve the level of medical and health expenditure,but control the structure and proportion of health expenditure to maximize the effectiveness of health expenditure.Draw lessons from foreign experience to use flexible retirement system;At the same time,middle-aged and elderly people should take the initiative to learn relevant policies,understand relevant information,eliminate gender issues in employment,and maintain good living habits.