城镇居民医疗保险可持续发展的筹资模式研究

项目名称： 城镇居民医疗保险可持续发展的筹资模式研究

项目编号： No.70873024

项目类型： 面上项目

立项/批准年度： 2009

项目学科： 轻工业、手工业

项目作者： 应晓华

作者单位： 复旦大学

项目金额： 25万元

中文摘要： 2007年开始推行的城镇居民医疗保险，覆盖城镇中的儿童、老人、就业年龄无业人口。该保险的筹资来自政府和家庭，且面临筹资可持续、水平差异较大、水平相对较低的问题。本研究旨在明确筹资水平、政府筹资作用、以及政府和家庭筹资关系。研究收集了86个城市2007和2009年的保险方案和城市信息，并通过入户调查，收集了1842户家庭和5974个人的医疗保险需求和意愿支付情况。研究发现，当前城市居民保险保险儿童、成人、老人保险保费分别为96、245和250元，而政府筹资在儿童、老人中贡献超过50%。2009年的保费比2007年更高，政府投入也更多，作用更大。人均收入和地方财政收入是影响保费和政府投入的显著因素。在不同政府补贴水平下（70元、100元、120元），如对保险福利包进行不同程度的完善，则家庭意愿支付水平也不一样，处于100元的政府补贴时，家庭一员支付水平最高，其次为120元政府补贴方案。这表明适宜的政府补贴能带来更高的意愿支付和筹资水平。此外，收入、区域等都是影响意愿支付的因素。

中文关键词： 城镇居民医疗保险；筹资；政府筹资；意愿支付；社会保险

英文摘要： China launched Urban Resident Basic Medical Insurance(URBMI) in 2007. It covers children, unemployed and eldly who live in urban areas. URBMI is voluntary and finance from government subsidy and household payment. However, it is facing the regional disparities and relatively low level of financing. This study aims to improve financing efficiency through identify the financing level, government's role in financing, and exploring relationship between government subsidy and household financing. We collected 86 cities' health insurance's document, and conducted survey in 1842 household and 5974 independent. This study found URBMI's premium per capita per year for children, unemployed and elderly were RMB96, RMB245 and RMB250 in 2009. The share of government subsidy to total premium for children or elderly were more than 50%. The premium and government subsidy in 2009 were higher than that of in 2007. We analyzed the factors influencing premium and government subsidy for URBMI through multivariate model. Income per capita and local government revenue are positively related to the premium as well as to the government subsidy. Contingent valuation method was used to ask household's WTP if benefit package enlarged based on the different different government subsidy of RMB 70, RMB 100 and RMB 120 per capita per year. Compared with RMB 120 government subsidy level, people in subsidy of RMB 70 group would like pay less money. However, the WTP of respondents with government subsidy of RMB 100 increase compared with respondents in RMB 120 subsidy group. Even though government subsidies' effect on households' WTP are no statistical significances, the result indicates that the households' WTP may not be positively related to government subsidy level. The region is also the key determinant on household's WTP. Households with higher income are likely to pay high WTP than that of people with lower income. It's possible that household have maximum WTP in a certain government subsidy level, and the WTP will decrease when below or above this subsidy level.

英文关键词： urban resident basic medical insurance; financing; government financing; willingness to pay; social health insurance