Heterogeneity of the Impact of the Social Old-Age Insurance and the Medical Insurance on the Mortality Risk of the Elderly.

Wangchun Wu,Chunhua Li,Bin Gao

doi:10.3389/fpubh.2022.807384

Abstract

Based on the frailty Cox model, this paper analyzes CLHLS data from 2008 to 2017/2018 to examine the impact of the social old-age insurance and the medical insurance on the mortality risk of the elderly based on the age structures, urban/rural areas and regions. The results reveal the heterogeneous impact as follows. In terms of the age structures, the social old-age insurance significantly reduces the mortality risk of the elderly aged below 80, but has no significant impact on the elderly aged 80 and above, whereas the medical insurance significantly reduces the mortality risk of the elderly aged 80 and above, but has no significant impact on the elderly aged below 80. In urban/rural areas and different regions, the social old-age insurance has no significant impact on the mortality risk of the elderly, whereas the social medical insurance significantly increases the mortality risk of the elderly in urban areas and the East, and reduces that of the elderly in rural areas and the Middle and the West. When implementing the insurances, China should pay attention to the different attributes of the elderly to guarantee the service quality, including the age structures, urban/rural areas and regions. A full consideration should be given to the allocation of investment and social security resources, so as to address the issue of the mismatch between the supply and demand of medical resources, and finally achieve the success of healthy aging and health equity.

Highlights

The 14th Five-Year Plan in China proposes that we should develop a fair, unified, and sustainable multi-tiered social security system that covers the entire population in both urban and rural areas
When the control variables are added (Model 14 and Model 16), the social old-age insurance has no significant impact on the mortality risk, but the social medical insurance still reduces the risk immensely
The main purpose of this paper is to investigate the heterogeneity of the social old-age insurance and the medical insurance on the mortality risk of the elderly in different ages and different regions under the background of the increasing aging in China

Summary

Introduction

The 14th Five-Year Plan in China proposes that we should develop a fair, unified, and sustainable multi-tiered social security system that covers the entire population in both urban and rural areas. Social insurance is an important part of the social security system, in which the social old-age insurance and the social medical insurance are the core content. In terms of the Basic Medical Insurance, some regions are in the leading position of the insurance integration, especially in developed regions. In January 2016, the State Council issued The Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents, requiring the whole nation to Heterogeneity of Elderly’s Mortality Risk promote the integration of The Medical Insurance System for Urban Residents and The New Rural Cooperative Medical System, and gradually establish a unified medical insurance system for urban and rural residents. Almost all regions in China have completed this task [2]

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