新農合制度對農村勞動力流動的影響
發(fā)布時間：2018-11-21 15:12
【摘要】：農村醫(yī)療保障體系的構建和完善是我國社會保障體系的一大難點,也是我國社會保障體系建設的重點部分。新型農村合作醫(yī)療制度,簡稱"新農合"。自2003年在部分省市試點,并逐漸在全國范圍內推廣開來。新型農村合作醫(yī)療其目的在于緩解農村居民醫(yī)療衛(wèi)生支出壓力,防止"因病致貧,因病返貧"現象的再生的醫(yī)療制度。它由中央政府、地方政府和農戶三方共同籌資建立,是以住院統(tǒng)籌和門診統(tǒng)籌為主要框架的新農合基金,在解決農民"看病難、看病貴"的問題上發(fā)揮了重要作用。在新農合實施的十幾年以來,其在一定程度上降低了農民的醫(yī)療衛(wèi)生支出壓力、改善了基層醫(yī)療衛(wèi)生條件,有效的提高了廣大農民的醫(yī)療保障水平,提升了醫(yī)療衛(wèi)生整體福利。然而新農合政策在制度上要求農民在其戶籍所在地繳費參合,并在當地衛(wèi)生機構看病報銷享受補償。對于新農合參與者在異地報銷,不僅存在時間上的不及時性和手續(xù)繁雜等情況以外,還面臨著報銷比例下降與起付線增高的情況。這樣新農合制度實際上對醫(yī)療保險在地域上做了限制。對于廣大農民來說,在外務工流入地享受不到當地的醫(yī)療保障,新農合制度又由于地域上的限制變相增加了外出務工的成本。在一定程度上,新農合制度有可能對農村勞動力在城鄉(xiāng)之間的流動產生影響。本文在此背景之下分析農民參加新農合政策是否會使農民更加傾向于留在本地務農與工作。通過以是否參合為選擇變量分析新農合制度對農村勞動力流動的影響,進而為新農合統(tǒng)籌層次提出合理化建議。對于影響農村勞動力流動的新因素進行分析,有利于通過政策調整引導農村勞動力合理流動,保障農民福利的同時繼續(xù)有效推進城鎮(zhèn)化建設。在此研究思路之下本文的主要內容和結構安排如下:第一部分為緒論。主要介紹了關于研究的背景及在實際中的意義。第二部分為國內與國外關于勞動力流動及醫(yī)療保險對其影響的研究成果綜述。對國內外關于勞動力流動、勞動力遷移以及醫(yī)療保險制度對于農村勞動力流動影響理論進行歸納綜述。從理論分析的脈絡中,尋找分析影響勞動力流動的因素,并在此基礎上尋找新型農村合作醫(yī)療這一新因素可能對農村勞動力流動產生影響的原因。在理論分析過程中主要分析了國外經典勞動力流動理論包括推拉理論、劉易斯理論和托達羅模型,同時分析國內方面對于勞動力流動的動機和原因的研究,以及醫(yī)療保險對勞動力流動的影響。第三部分在理論分析的基礎之上,根據效用模型對于所建實證模型的作用機制做簡要分析,農村勞動力根據流出地以及勞動力輸入地總效用大小為依據來決定是否進行務工地點的改變,同時從社會保障總體角度分析其對勞動力供需的影響。第四部分利用"中國健康及營養(yǎng)數據"及各年度統(tǒng)計年鑒數據,利用微觀計量經濟學方法建立二元選擇模型,研究是否參與新農合對農村勞動力流動的影響。并且在勞動力流動是否參加受新農合影響研究的基礎之上,建立多元離散選擇模型分析農村勞動力在新農合制度異地報銷比例差異的影響之下對務工地點在縣內、省內縣外以及省外之間進行重新選擇的影響。第五部分根據實證分析的結果,并結合理論知識及現實情況提出合理化建議,促進農村勞動力在城鄉(xiāng)之間合理流動,緩解農村就業(yè)壓力的同時為城市提供充足的勞動力供給,促進城鄉(xiāng)健康快速發(fā)展。
[Abstract]:The construction and perfection of the rural medical security system is a difficult point of the social security system in our country, and it is also the key part of the construction of the social security system in our country. New rural cooperative medical system, short of "Xin Nong-in". It is a pilot in some provinces and cities in 2003 and is gradually spread across the country. The purpose of the new rural cooperative medical system is to relieve the pressure of medical and health expenditure of rural residents and prevent the regeneration of the "The disease is poor due to the disease, and the disease is returned to the poor." phenomenon. It is set up by the central government, the local government and the farmer's three-party co-financing, which is the new agriculture and closing fund which is the main framework of the integrated and outpatient service of the hospital, and plays an important role in solving the problem of the farmer's "It's hard to see the disease. It's expensive to see the disease.". More than ten years after the implementation of the new agriculture, it has reduced the pressure of the farmers' medical and health expenditure to a certain extent, has improved the medical and health conditions of the grass-roots level, effectively improves the medical security level of the farmers, and improves the overall welfare of the medical and health. However, the new non-agricultural co-operation policy, on the system, requires the farmers to pay the contributions at their place of residence, and to compensate for the reimbursement of the medical treatment of the local health institutions. In addition to the non-timeliness of time and the complexity of procedures, the reimbursement rate is also facing the increase of the reimbursement rate and the increase of the pay-down line for the new non-agricultural co-participants in the off-site reimbursement. Such a new farming system actually limits the area of health insurance. For a large number of farmers, the outside migrant workers can't enjoy the local medical security, and the new farming system increases the cost of the migrant workers in a disguised form due to the regional limitation. To some extent, the new farming system is likely to have an impact on the flow of rural labour between urban and rural areas. Under this background, it is necessary to analyze whether the farmers' participation in the new agriculture-in-one policy will make the farmers more inclined to stay in the local farming and work. The influence of the new farming system on the flow of the rural labor force is analyzed, and the reasonable suggestions are put forward for the new non-agricultural co-integration level. The paper analyses the new factors that affect the rural labor force flow, which is conducive to the rational flow of the rural labor force through the policy adjustment, and to guarantee the welfare of the farmers and to continue to promote the construction of the urbanization effectively. The main contents and structure of this paper are as follows: the first part is the introduction. The background and significance of the study are introduced. The second part is a review of the research results on the impact of the domestic and foreign labor movement and medical insurance. This paper summarizes the theories of labor mobility, labor migration and medical insurance system in the rural labor force. In the context of the analysis of the theory, the author finds out the factors that influence the flow of the labor force, and on the basis of this, it is possible to find out the influence of the new factors of the new rural cooperative medical service on the flow of the rural labor force. In the course of the theoretical analysis, the foreign classical labor flow theory is mainly analyzed, including the push-pull theory, the Lewis's theory and the Todaro model. At the same time, the study of the motive and cause of the labor flow in the country and the effect of the medical insurance on the labor force flow are analyzed. On the basis of the theoretical analysis, the third part makes a brief analysis on the mechanism of the utility model on the basis of the utility model, and the rural labor force decides whether to make the change of the work place according to the total utility size of the flow and the input of the labor force. At the same time, it analyzes its influence on the supply and demand of the labor force from the general angle of social security. The fourth part uses the "China's health and nutrition data" and the annual statistical yearbook data, and uses the micro-econometrics method to set up a binary selection model to study whether to participate in the influence of the new agriculture on the rural labor force. and a multi-element discrete selection model is established to analyze the influence of the rural labor force under the influence of the difference of the reimbursement proportion of the new non-farming system on the basis of whether the labor mobility participates in the research on the influence of the new agriculture, The effect of re-selection between the outside of the province and the outside of the province. The fifth part, based on the results of the empirical analysis, puts forward reasonable suggestions on the basis of the theoretical knowledge and the reality, to promote the rational flow of the rural labor force between the urban and rural areas, to alleviate the rural employment pressure, to provide adequate labor supply for the city, and to promote the rapid development of urban and rural health.
【學位授予單位】：東北財經大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：F323.6;F842.684;F323.89
本文編號：2347342
[Abstract]:The construction and perfection of the rural medical security system is a difficult point of the social security system in our country, and it is also the key part of the construction of the social security system in our country. New rural cooperative medical system, short of "Xin Nong-in". It is a pilot in some provinces and cities in 2003 and is gradually spread across the country. The purpose of the new rural cooperative medical system is to relieve the pressure of medical and health expenditure of rural residents and prevent the regeneration of the "The disease is poor due to the disease, and the disease is returned to the poor." phenomenon. It is set up by the central government, the local government and the farmer's three-party co-financing, which is the new agriculture and closing fund which is the main framework of the integrated and outpatient service of the hospital, and plays an important role in solving the problem of the farmer's "It's hard to see the disease. It's expensive to see the disease.". More than ten years after the implementation of the new agriculture, it has reduced the pressure of the farmers' medical and health expenditure to a certain extent, has improved the medical and health conditions of the grass-roots level, effectively improves the medical security level of the farmers, and improves the overall welfare of the medical and health. However, the new non-agricultural co-operation policy, on the system, requires the farmers to pay the contributions at their place of residence, and to compensate for the reimbursement of the medical treatment of the local health institutions. In addition to the non-timeliness of time and the complexity of procedures, the reimbursement rate is also facing the increase of the reimbursement rate and the increase of the pay-down line for the new non-agricultural co-participants in the off-site reimbursement. Such a new farming system actually limits the area of health insurance. For a large number of farmers, the outside migrant workers can't enjoy the local medical security, and the new farming system increases the cost of the migrant workers in a disguised form due to the regional limitation. To some extent, the new farming system is likely to have an impact on the flow of rural labour between urban and rural areas. Under this background, it is necessary to analyze whether the farmers' participation in the new agriculture-in-one policy will make the farmers more inclined to stay in the local farming and work. The influence of the new farming system on the flow of the rural labor force is analyzed, and the reasonable suggestions are put forward for the new non-agricultural co-integration level. The paper analyses the new factors that affect the rural labor force flow, which is conducive to the rational flow of the rural labor force through the policy adjustment, and to guarantee the welfare of the farmers and to continue to promote the construction of the urbanization effectively. The main contents and structure of this paper are as follows: the first part is the introduction. The background and significance of the study are introduced. The second part is a review of the research results on the impact of the domestic and foreign labor movement and medical insurance. This paper summarizes the theories of labor mobility, labor migration and medical insurance system in the rural labor force. In the context of the analysis of the theory, the author finds out the factors that influence the flow of the labor force, and on the basis of this, it is possible to find out the influence of the new factors of the new rural cooperative medical service on the flow of the rural labor force. In the course of the theoretical analysis, the foreign classical labor flow theory is mainly analyzed, including the push-pull theory, the Lewis's theory and the Todaro model. At the same time, the study of the motive and cause of the labor flow in the country and the effect of the medical insurance on the labor force flow are analyzed. On the basis of the theoretical analysis, the third part makes a brief analysis on the mechanism of the utility model on the basis of the utility model, and the rural labor force decides whether to make the change of the work place according to the total utility size of the flow and the input of the labor force. At the same time, it analyzes its influence on the supply and demand of the labor force from the general angle of social security. The fourth part uses the "China's health and nutrition data" and the annual statistical yearbook data, and uses the micro-econometrics method to set up a binary selection model to study whether to participate in the influence of the new agriculture on the rural labor force. and a multi-element discrete selection model is established to analyze the influence of the rural labor force under the influence of the difference of the reimbursement proportion of the new non-farming system on the basis of whether the labor mobility participates in the research on the influence of the new agriculture, The effect of re-selection between the outside of the province and the outside of the province. The fifth part, based on the results of the empirical analysis, puts forward reasonable suggestions on the basis of the theoretical knowledge and the reality, to promote the rational flow of the rural labor force between the urban and rural areas, to alleviate the rural employment pressure, to provide adequate labor supply for the city, and to promote the rapid development of urban and rural health.
【學位授予單位】：東北財經大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：F323.6;F842.684;F323.89
【參考文獻】
中國期刊全文數據庫 前10條
1 賈男;馬俊龍;;非攜帶式醫(yī)保對農村勞動力流動的鎖定效應研究[J];管理世界;2015年09期
2 寧滿秀;劉進;;新型農村合作醫(yī)療制度對農戶外出務工地點選擇的影響研究[J];財經論叢;2014年04期
3 楊剛強;孟霞;石欣;高威;;基本公共服務與農村勞動力轉移的關系研究[J];宏觀經濟管理;2013年08期
4 鄭旭;;芻議我國制約農村剩余勞動力轉移的制度因素[J];商業(yè)經濟;2012年11期
5 秦雪征;鄭直;;新農合對農村勞動力遷移的影響:基于全國性面板數據的分析[J];中國農村經濟;2011年10期
6 周曉艷;汪德華;李鈞鵬;;新型農村合作醫(yī)療對中國農村居民儲蓄行為影響的實證分析[J];經濟科學;2011年02期
7 王琴;;從“民工潮”到“民工荒”——我國農村剩余勞動力轉移的制度瓶頸探析[J];安徽農業(yè)科學;2010年34期
8 余勃;賈金榮;;農村剩余勞動力轉移的制度性阻滯因素研究[J];改革與戰(zhàn)略;2010年02期
9 李夢;黃敬寶;;劉易斯模型與我國農村剩余勞動力轉移[J];消費導刊;2010年03期
10 毛淑娟;;城鄉(xiāng)統(tǒng)籌視角下我國新農合制度發(fā)展與制度整合分析[J];社會保障研究;2010年01期
，本文編號：2347342
本文鏈接：http://sikaile.net/shekelunwen/shehuibaozhanglunwen/2347342.html
