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已有研究表明,健康水平会影响个人心理状态,进而影响被保险人健康行为的选择。为检验医疗保险对不健康行为的影响是否受到参保者健康水平的干扰,利用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2011年和2013年的面板数据,按照自评健康水平的差异将样本分为自评健康较好、一般、较差三个组别,利用Probit模型分别研究医疗保险对抽烟、过度饮酒、不经常运动三种不健康行为的影响。研究发现,医疗保险对自评健康较差组抽烟行为的影响较自评健康较好组更为显著,存在异质性;医疗保险对过度饮酒和不经常运动行为的影响均不受健康水平的干扰。基于此,提出医疗保险制度的设计与改革应做好三方面工作,包括提高医保制度体系的精准性,树立健康导向、预防优先、质量至上的理念,改善医保双方信息不对称的格局。
Studies have shown that the level of health will affect the psychological status of individuals, thereby affecting the insured’s health behavior choices. To test whether the impact of health insurance on unhealthy behaviors is affected by the health status of insured participants, panel data of China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2013 are used to assess the impact of health insurance on self-rated health status The samples were divided into three groups with good health, general health and poor health. The Probit model was used to study the impact of medical insurance on three unhealthy behaviors: smoking, excessive alcohol consumption and infrequent exercise. The study found that the impact of medical insurance on self-rated poor health smoking behavior is more significant than self-rated good health group, there is heterogeneity; medical insurance on excessive alcohol consumption and infrequent exercise are not affected by the health level interference. Based on this, it is suggested that the design and reform of the medical insurance system should do a good job in three aspects, including improving the accuracy of the medical insurance system, establishing the concept of health orientation, prevention priority and quality first, and improving the information asymmetry between the two parties.