【作者】 王锐；

【导师】 张瑞纲；

【作者基本信息】 广西大学 ， 保险（专业学位）， 2024， 硕士

【摘要】 普惠型医疗保险又名惠民保,是我国在各地开展的以实现公平可得、保障适度、覆盖范围广泛、适应各地“大城市大农村”二元结构的城乡居民医疗保障需求的普惠型保险产品和服务。旨在推进基本医疗保险与商业保险协调融合发展、构建“共享、共建、共治”医保治理体系,对完善多层次医疗保障体系、提升人民群众整体生活水平、实现共同富裕均有重要意义。根据已有研究表明,普惠医疗保险作为一种新兴产物在快速发展中仍然存在着不完善问题,如逆向选择风险大、健康个体退保可能导致市场中的“死亡螺旋”现象,会削弱投保人对其可持续发展的信心,进而影响参保率。因此,在新时代扎实推进共同富裕的背景下,本文立足于普惠医疗保险的概念解析、需求理论基础,以及南宁市普惠医疗保险惠邕保的发展现状。从需求端居民的投保意愿视角出发,以南宁市推出的“惠邕保”为例,预测惠邕保的需求端规模以及深入探究居民购买惠邕保的影响因素,进而提出增强我国居民对普惠型医疗保险需求意愿的建议,完善我国多层次医疗保障体系的发展。本文对惠邕保需求规模的预测是建立在灰色预测GM(1,1)模型基础上,预测结果为惠邕保在未来六年参保人数潜在的市场需求预测规模呈上升趋势,预计到2028年在保守的10%参保比例下参保人数需求规模为85.99万人,更为积极的30%参保比例假设下需求达257.96万人,该结果为惠邕保供给端提供了参考性的发展目标。随后选取广西壮族自治区南宁市为调查样本,通过实地发放问卷和线上收集调查南宁市居民对惠邕保的购买意愿,利用Logistic模型对南宁市居民对惠邕保的需求影响因素进行实证检验与分析,结果显示消费者的年龄、收入、健康状况、对惠邕保的了解、给付比例、免赔额认知、参保资格认知、特效药吸引力、惠邕保了解途径数量、曾经是否在微信/支付宝等平台购买过保险十个因素在5%的置信水平下对惠邕保的需求意愿具有显著影响。最后,基于现状分析与实证结果分析,本文提出以下建议:政府应拓宽筹资渠道、设定合理的赔付率标准、优化宣传策略、加强宣传渠道建设;保险公司应推动产品升级和服务创新、加大宣传力度,提高消费者对普惠型医疗保险特点的认知程度;而消费者亦应提升自身的互联网素养,增强线上参保能力。更多还原

【Abstract】 Universal medical insurance,also known as huimin insurance,is a universal insurance product and service carried out in various parts of China to achieve fairness and accessibility,moderate protection,and broad coverage,adapting to the needs of urban and rural residents for medical insurance in the dual structure of "big cities and big rural areas" in various parts of the country.The aim is to promote the coordinated and integrated development of basic medical insurance and commercial insurance,and to build a "sharing,coconstruction and co-management" medical insurance governance system,which is of great significance to perfecting the multi-level medical insurance system,upgrading the overall living standard of the people,and realizing the common prosperity of the people.According to existing studies,universal health insurance,as a new product,still has imperfections in its rapid development,such as the high risk of adverse selection and the "death spiral" phenomenon in the market caused by the withdrawal of healthy individuals,which will weaken the confidence of the insured in its sustainable development,thus affecting the enrollment rate.Therefore,in the context of promoting common prosperity in the new era,this paper is based on the conceptual analysis of universal health insurance,the theoretical basis of demand,and the development status of Nanning City’s universal health insurance Huiyong Insurance.From the perspective of residents’ willingness to take out insurance on the demand side,this paper takes "Huiyong Insurance" launched by Nanning City as an example,predicts the scale of Huiyong Insurance on the demand side and explores the influencing factors of residents’ purchasing of Huiyong Insurance,and then puts forward the suggestions to enhance the willingness of residents to demand for universal medical insurance,so as to improve the development of China’s multilevel medical insurance system.In this paper,the prediction of the demand scale of Huiyong insurance is based on the gray prediction model GM(1,1),the prediction result is that the potential market demand scale of Huiyong insurance in the next six years is on the rise,and it is expected that the demand scale of the number of participants will be 859,900 people under the conservative 10%participation ratio in 2028,and the demand will be 2,579,600 people under the more aggressive assumption of 30% participation ratio,and this result is a good example of the demand for Huiyong insurance.This result provides a reference development target for the supply side of Huiyong insurance.Subsequently,Nanning City,Guangxi Zhuang Autonomous Region was selected as a survey sample,and the questionnaire was distributed in the field and collected online to investigate Nanning residents’ willingness to purchase Huiyong Insurance,and the Logistic model was used to empirically test and analyze the factors influencing the demand for Huiyong Insurance by the Nanning residents.The results show that ten factors,namely age,income,health status,knowledge of Huiyong Insurance,benefit ratio,perception of deductible,participation in the insurance,attractiveness of special medicine,number of ways to know about Huiyong Insurance,and whether they have ever purchased insurance on We Chat/Alipay and other platforms,have a significant impact on the willingness to demand for Huiyong Insurance at the 5 percent confidence level.Finally,based on the analysis of the current situation and the empirical results,this paper puts forward the following recommendations: the government should broaden the financing channels,set a reasonable standard of compensation rate,optimize the publicity strategy,and strengthen the construction of publicity channels;the insurance companies should promote the product upgrading and service innovation,and intensify the publicity efforts to improve the consumers’ awareness of the characteristics of the universal health insurance;and the consumers should improve their Internet literacy,and increase their online Enrollment.更多还原