“以医促养”还是“以养促养”:医疗保险与养老金的健康绩效比较

Investment Rating - The report suggests a preference for "pension-led health promotion" over "medical insurance-led health promotion" for improving elderly health outcomes [1][3]. Core Insights - The empirical results indicate that pension income significantly enhances elderly individuals' subjective health, which in turn positively affects their physiological health. In contrast, medical insurance spending shows a significant negative correlation with both subjective and physiological health [1][3][11]. - The study advocates for a shift in China's health security system from a disease treatment focus to one that relies on pension funds to purchase elder care services, thereby improving the quality of life for the elderly [1][3]. Summary by Sections Introduction - As of 2018, the elderly population (aged 60 and above) in China reached 249 million, accounting for 17.9% of the total population. The basic pension insurance expenditure has increased from 312.2 billion yuan in 2003 to 4,755 billion yuan in 2018, reflecting a growth rate of 15% [1][3]. - The report highlights the increasing financial burden on families and the government due to rising pension and medical insurance expenditures, which are projected to continue growing rapidly [1][3]. Methodology - The study utilizes data from the China Longitudinal Healthy Longevity Survey (CLHLS) 2014, employing structural equation modeling to estimate the health outcomes associated with pension and medical insurance [5][6]. - The analysis includes subjective health assessments and physiological health indicators, with a focus on the mediating effects of living conditions, fruit intake, timely medical treatment, and economic status [5][11]. Results - The structural equation model indicates that pension income has a positive effect on subjective health (coefficient of 0.076) and a negative effect on physiological health (coefficient of -0.017), both significant at the 0.1% level. Conversely, medical insurance shows a negative correlation with both health measures [11][13]. - The path analysis reveals that pension income improves living conditions and dietary habits, which subsequently enhance both subjective and physiological health [11][15]. Conclusion - The findings suggest that pension income is more effective than medical insurance in promoting elderly health, emphasizing the need for policy adjustments to prioritize pension-led health strategies [1][3][11].