《保险研究》20201202-《健康风险、医疗保险与消费》（邵全权、郝天琪）

［摘   要］本文利用动态规划的值函数迭代算法,建立只存在健康风险情形下的基准模型作为参照系,然后建立同时引入健康风险和医疗保险保障的模型,分别模拟城职保、城居保和新农合对消费和消费序列的影响,研究医疗保险对居民消费的影响。研究发现,城职保和城居保可以提高消费和消费序列,新农合却会降低消费和消费序列。利用CFPS 2010~2018年5轮基线数据构成的混合截面数据进行实证检验,发现城职保和城居保显著提高了家庭人均总消费,在支出分项中,也显著提高了医疗消费和食品、衣着等日常消费以及教育文娱消费；而新农合则显著抑制了总消费和分项消费。对不同收入和年龄群体进行异质性检验发现,医保对低收入、高年龄群体消费的影响幅度最大。

［关键词］医疗保险；健康风险；消费；贝尔曼方程

［基金项目］本文是天津市哲学社会科学规划课题（TJYJ18-002）的阶段性研究成果。作者感谢基本科研费资助。

［作者简介］邵全权,南开大学金融学院副教授；郝天琪,南开大学金融学院硕士研究生。

Health Risk,Medical Insurance and Consumption

SHAO Quan-quan,HAO Tian-qi

Abstract：This paper used the value function iterative algorithm of dynamic programming to establish a benchmark model of which only health risks was considered,and then established a model that introduced both health risks and medical insurance protection to simulate the impact of urban employee insurance,urban resident insurance and new rural cooperative insurance on consumption and consumption sequence.It is found that urban employee insurance and urban resident insurance can increase consumption and consumption sequence,but new rural cooperative medical insurance has the opposite effect.Subsequently,pooled cross-sectional data formed by 5 rounds baseline data of CFPS 2010-2018 was used to conduct an empirical test.It was found that urban employee insurance and urban resident insurance significantly increased the total household consumption per capita.In the expenditure category,it also significantly increased medical,food,clothing,education as well as entertainment consumption.But the new rural cooperative medical insurance significantly suppressed total consumption and sub-items.At the same time,the heterogeneity test of different income and age groups found that social medical insurance had the greatest impact on the consumption of low-income and high-age groups.

Key words：medical insurance; health risk; consumption; Bellman equation