新农合制度对农村劳动力流动的影响
发布时间：2018-11-21 15:12
【摘要】：农村医疗保障体系的构建和完善是我国社会保障体系的一大难点,也是我国社会保障体系建设的重点部分。新型农村合作医疗制度,简称"新农合"。自2003年在部分省市试点,并逐渐在全国范围内推广开来。新型农村合作医疗其目的在于缓解农村居民医疗卫生支出压力,防止"因病致贫,因病返贫"现象的再生的医疗制度。它由中央政府、地方政府和农户三方共同筹资建立,是以住院统筹和门诊统筹为主要框架的新农合基金,在解决农民"看病难、看病贵"的问题上发挥了重要作用。在新农合实施的十几年以来,其在一定程度上降低了农民的医疗卫生支出压力、改善了基层医疗卫生条件,有效的提高了广大农民的医疗保障水平,提升了医疗卫生整体福利。然而新农合政策在制度上要求农民在其户籍所在地缴费参合,并在当地卫生机构看病报销享受补偿。对于新农合参与者在异地报销,不仅存在时间上的不及时性和手续繁杂等情况以外,还面临着报销比例下降与起付线增高的情况。这样新农合制度实际上对医疗保险在地域上做了限制。对于广大农民来说,在外务工流入地享受不到当地的医疗保障,新农合制度又由于地域上的限制变相增加了外出务工的成本。在一定程度上,新农合制度有可能对农村劳动力在城乡之间的流动产生影响。本文在此背景之下分析农民参加新农合政策是否会使农民更加倾向于留在本地务农与工作。通过以是否参合为选择变量分析新农合制度对农村劳动力流动的影响,进而为新农合统筹层次提出合理化建议。对于影响农村劳动力流动的新因素进行分析,有利于通过政策调整引导农村劳动力合理流动,保障农民福利的同时继续有效推进城镇化建设。在此研究思路之下本文的主要内容和结构安排如下:第一部分为绪论。主要介绍了关于研究的背景及在实际中的意义。第二部分为国内与国外关于劳动力流动及医疗保险对其影响的研究成果综述。对国内外关于劳动力流动、劳动力迁移以及医疗保险制度对于农村劳动力流动影响理论进行归纳综述。从理论分析的脉络中,寻找分析影响劳动力流动的因素,并在此基础上寻找新型农村合作医疗这一新因素可能对农村劳动力流动产生影响的原因。在理论分析过程中主要分析了国外经典劳动力流动理论包括推拉理论、刘易斯理论和托达罗模型,同时分析国内方面对于劳动力流动的动机和原因的研究,以及医疗保险对劳动力流动的影响。第三部分在理论分析的基础之上,根据效用模型对于所建实证模型的作用机制做简要分析,农村劳动力根据流出地以及劳动力输入地总效用大小为依据来决定是否进行务工地点的改变,同时从社会保障总体角度分析其对劳动力供需的影响。第四部分利用"中国健康及营养数据"及各年度统计年鉴数据,利用微观计量经济学方法建立二元选择模型,研究是否参与新农合对农村劳动力流动的影响。并且在劳动力流动是否参加受新农合影响研究的基础之上,建立多元离散选择模型分析农村劳动力在新农合制度异地报销比例差异的影响之下对务工地点在县内、省内县外以及省外之间进行重新选择的影响。第五部分根据实证分析的结果,并结合理论知识及现实情况提出合理化建议,促进农村劳动力在城乡之间合理流动,缓解农村就业压力的同时为城市提供充足的劳动力供给,促进城乡健康快速发展。
[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.
【学位授予单位】：东北财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F323.6;F842.684;F323.89
本文编号：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.
【学位授予单位】：东北财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F323.6;F842.684;F323.89
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