【作者】 王红；

【导师】 曲丹；

【作者基本信息】 湖南大学 ， 应用经济学， 2022， 硕士

【摘要】 根据相关公开数据,在2019年中国人均预期寿命为77.47岁,预计到2050年将提高到82.28岁,增长4.81岁。随着人口老龄化越来越严重,生育率也逐渐降低,尽管国家目前开放三胎政策,但是生育率的提升水平和劳动力的短期供应存在滞后效应和其他因素的影响。由于出生率降低和人民预期寿命延长,导致“用工荒”和人口老龄化问题突出。同时预期寿命延长也会让稳态下的出生率下降、财政卫生支出提高、人均劳劳动生产率下降。在这种背景下,中国的人口红利在逐渐下降,所以研究影响中老年人劳动供给的因素具有重要意义,可以为中老年人力资本的发展和积极养老提供理论支撑。中老年的劳动供给与医疗卫生支出有着很多的关系,当居民享受的政府医疗卫生支出增加,居民的健康水平提高,在拥有比较丰富分工作经验和工作技能下,可以延长劳动力供给,缓解市场短缺的问题。本文首先对相关文献进行梳理总结,并对我国医疗卫生支出和健康人力资本进行了现状分析。然后结合相关的经济学理论和实际,就医疗卫生支出和健康人力资本对中老年人的劳动供给影响机理进行分析,认为其可以通过人力资本来影响中老年人劳动供给决策。实证方面,本文利用2018年中国健康与养老追踪调查(CHARLS)数据,利用Probit模型和OLS模型分别研究医疗卫生支出、健康人力资本对中老年人劳动参与和劳动时长的影响,并进行了中介效应检验和异质性分析及稳健性分析,还选取滞后一期的2017年医疗卫生支出作为医疗卫生支出的工具变量来处理内生性问题。结果表明中老年人的劳动时长会随医疗卫生支出的增加而增加。分医疗支出种类来看,政府医疗卫生支出增加不利于中老年劳动参与和劳动时长增加,社会医疗卫生支出的增加都会使中老年劳动参与和劳动时长增加,健康人力资本对劳动参与和劳动时长的中介效应影响是正向显著的,45-60岁、60-70岁及乡村地区以及中高等收入及以上家庭的结果与总样本的结果一致,医疗卫生支出对中老年人劳动参与和劳动时长为正向影响;分性别来看,医疗卫生支出对退休之后的男性的劳动供给更加显著,对退休之前女性的劳动供给更加显著。最后使用另一种回归模型Logit模型和Tobit模型对全样本进行回归,得到的结果与之前结果相一致,医疗卫生支出和健康人力资本对中老年人劳动参与和劳动时长的边际效应均显著为正,表明实证结果较为稳健。根据研究结论,本文从医疗卫生支出水平和效率、弹性退休制度和积极养老提出政策建议,要提高医疗卫生支出水平,但是控制卫生支出的结构和比例,使卫生支出达到效用最大化;借鉴国外的经验使用弹性退休制度;同时中老年人应主动学习相关政策,了解相关信息,消除就业的性别问题,保持良好的生活习惯。更多还原

【Abstract】 According to relevant public data,the average life expectancy in China was77.47 years in 2019 and is expected to rise to 82.28 years in 2050,an increase of 4.81 years.With the aging of the population becoming more and more serious,the fertility rate is gradually decreasing.Although the country is currently open to the three-child policy,the improvement level of fertility rate and the short-term supply of labor force are affected by lag effect and other factors.Declining birth rates and longer life expectancy have led to a shortage of workers and an aging population.At the same time,longer life expectancy will lead to lower birth rates,higher health spending and lower productivity per worker.In this context,China’s demographic dividend is gradually declining,so it is of great significance to study the factors affecting the labor supply of the middle-aged and elderly,which can provide theoretical support for the development of human capital of the middle-aged and elderly and active pension.The labor supply of the middle-aged and the elderly has a lot to do with the medical and health cost.When the government medical and health cost of the residents increases,the health level of the residents improves,and with relatively rich working experience and skills,the labor supply can be extended to alleviate the problem of market shortage.This paper firstly summarizes recent literature and analyzes the current situation of medical and health cost and health human capital in China.Then combined with the recent economic theory,the mechanism of the impact of medical and health expenditure and health human capital on the labor supply of middle-aged and old people is analyzed,and it is believed that human capital can affect the labor supply decision of middle-aged and old people.Empirically,this paper uses the data of the newly released 2018 China Health and Old-age Care Tracking Survey(CHARLS),uses Probit model and OLS model to study the influence of medical and health expenditure and health human capital on labor participation and labor duration of middle-aged and elderly respectively,and conducts mediating effect test,heterogeneity analysis and robustness analysis.The medical and health expenditure in2017,which was one year behind,was also selected as an instrumental variable of medical and health expenditure to deal with endogeneity.The results show that the working hours of middle-aged and old people will increase with the increase of medical expenditure.In terms of the types of medical expenditure,the increase of government medical and health expenditure is not conducive to the increase of labor participation and working hours of middle-aged and elderly,while the increase of social medical and health expenditure will increase the labor participation and working hours of middle-aged and elderly.The mediating effect of health human capital on labor participation and working hours is positive and significant.The results of 45 to 60 years old,60 to 70 years old,rural areas and families with middle and high income and above are consistent with the results of the total sample.Medical and health expenditure has a positive impact on the labor participation and working time of the middle and old people;By gender,the labor supply of health care expenditure is more significant for men after retirement and for women before retirement.Finally,another regression model,Logit model and Tobit model,was used for the regression of the whole sample,and the results were consistent with the previous results.The marginal effects of medical and health expenditure and health human capital on labor participation and labor hours of middle-aged and elderly were significantly positive,indicating that the empirical results were relatively robust.From what has been discussed above,this paper puts forward policy suggestions from the level and efficiency of medical and health expenditure,flexible retirement system and active pension.We should improve the level of medical and health expenditure,but control the structure and proportion of health expenditure to maximize the effectiveness of health expenditure.Draw lessons from foreign experience to use flexible retirement system;At the same time,middle-aged and elderly people should take the initiative to learn relevant policies,understand relevant information,eliminate gender issues in employment,and maintain good living habits.更多还原