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Participation Behavior and Benefit Attribution of Medical Insurance for Informal Employees——Double Test Based on Adverse Selection and Positive Distribution Effect

【Authors】
HE Wen, SHEN Shuguang
【WorkUnit】
Sun Yat-sen University, 510275.
【Abstract】

At present, there is an inadequate and unbalanced development of medical insurance for informal employees. It will not only restrict the fairness and sustainability of the medical insurance system, but also hinder the comprehensive, coordinated and sustainable development of the economy and society. This paper uses the China Labor Dynamics Survey Data (CLDS) to study the determinants for informal employees to purchase the medical insurance and their benefit attribution. The results show that: On the one hand, when informal employees debate over to buy the medical insurance or not or which medical insurance policy to buy, their health risk has significant positive impact on their insurance decision, which indicates that the adverse selection effect is significant. On the other hand, low-income insured people have received better medical services and compensation from the medical insurance fund, and their health status has been significantly improved, so medical insurance has played a positive distribution role. However, the change in the insurance status and the improvement of reimbursement level will cause moral hazard while improving the accessibility of medical care, which will aggravate the problem of adverse selection, hinder the positive distribution effect, and have a negative impact on the establishment of a more equitable and sustainable health insurance system.


JEL:I18, H55

【KeyWords】
Informal Employees, Medical Insurance, Health, Adverse Selection, Positive Distribution