【作者】 孙悦；

【导师】 邢天才； 李杰；

【作者基本信息】 东北财经大学 ， 保险硕士（MI）（专业学位）， 2023， 硕士

【副题名】基于CHARLS数据的实证分析

【摘要】 在中国人口老龄化日趋严重,农村传统家庭与土地养老保障模式面临挑战的大环境下,为破解中国农村严重养老难题,以逐步实现城乡社会公共服务均等化,健全农村养老保障体系为目标,中国农村走过了一条从传统式家庭保障到集体经济保障再到社会养老保险探索与试点的发展道路。经过多年的发展,新型农村社会养老保险已经成为国家社会保障体系中不可缺少的组成部分,也是构建社会主义和谐社会的重要内容之一。按照党的十七大和十七届三中全会精神,国务院从2009年9月开始在全国范围内试行新型农村社会养老保险制度(以下简称“新农保”),以保障农村居民老年基本生活为目标,实行自愿参保原则。经过几年的实践,新农保已取得显著成效,但也存在一些亟待解决的问题。国务院明确2009年9月起正式开展新农保全国试点工作,覆盖10%县(市、区、旗)并逐步有序地扩大范围,到2012年9月将基本实现2853个县级行政区全部新农保试点,标志着农村社会养老保险制度建设进入了新时期。党的十八大以来,我国养老事业取得了阶段性飞跃,养老产业蓬勃发展,有效提升了对特困、低保、高龄群体的兜底保障力度,让老有所养、老有所医、老有所乐成为现实。十九大报告中提出“实施健康中国战略”,强调要“积极应对人口老龄化,构建养老、孝老、敬老政策体系和社会环境,推进医养结合,加快老龄事业和产业发展”。二十大报告指出“实施积极应对人口老龄化国家战略,发展养老事业和养老产业,优化孤寡老人服务,推动实现全体老年人享有基本养老服务”。如何妥善缓解人口老龄化对经济社会带来的冲击,在稳步提升老年群体的幸福感、获得感、安全感方面有着重要意义。在理论研究方面,本文首先对相关理论进行系统性梳理,通过探究新农保与农村居民医疗负担之间的因果关系,为本文研究提供理论支撑;在实证方面,依据前文的相关假设,利用CHARLS数据库中2018年数据作为研究样本,运用模糊断点回归模型分析新农保养老金对农村居民医疗负担的影响,将样本数据按照不同收入水平、不同健康状态进行回归分析。此外,充分考虑领取养老金收入所产生的“收入效应”和“挤出效应”,通过探究领取养老金前后样本的劳动参与变化;在稳健性检验中,首先将控制变量作为前置变量排除控制变量对实证结果的影响,其次,断点回归设计在一定程度上避免了内生性对实证结果的影响,但领取养老金的个体在就医问题方面可能存在自选择问题,为进一步验证实证结果的稳健性不受自选择问题和内生性问题的影响,本文使用Heckman+2SLS进一步验证了实证结果的稳健性检验。本文的创新点有以下两点:一是基于断点回归模型研究新农保在缓解农村居民医疗负担的影响,有效地避免了内生性问题对实证稳健性的影响。二是选题角度比较新颖,在现有的文献中,对新农保政策效果分析的文章较为丰富,但鲜有学者将新农保与医疗负担水平纳入同一框架进行研究。因此,本文进一步丰富了新农保的研究视角。更多还原

【Abstract】 Against the backdrop of an increasingly serious ageing population and challenges to the traditional family and land-based old-age security model in rural areas,China’s rural areas have undergone a process of transition from spontaneous,traditional family security to collective economic security and then exploration and piloting of a social old-age insurance system in order to solve the serious old-age problem in rural areas,thereby gradually promoting the equalisation of urban and rural social public services and improving the Rural old-age security system.In accordance with the spirit of the 17th National Congress of the Communist Party of China and the Third Plenary Session of the 17th CPC Central Committee began a nationwide pilot scheme of the New Rural Pension System(hereinafter referred to as"new rural insurance")in September 2009,with the objective of protecting the basic livelihood of rural residents in their old age and the principle of voluntary participation.The State Council clearly stipulated that the pilot scheme would be launched in September 2009,covering 10%of the counties(cities,districts and banners)in the country,and that the scope would be gradually expanded in an orderly manner,so that by September 2012,the pilot scheme would have been implemented in all 2853 counties in the country.Since the 18th National Congress of the Communist Party of China,China’s pension system has made a quantum leap forward and the pension industry has flourished,effectively enhancing the protection of the underprivileged,underprivileged and elderly groups and making old age care,medical care and happiness a reality.In the report of the 19th CPC National Congress,it is proposed to "implement the Health China Strategy2030",with special emphasis on "actively responding to the ageing of the population,building a policy system and social environment for the elderly,filial piety and respect for the elderly,promoting the integration of medical care,and accelerating the development of the cause and industry of the elderly".The Delivered at the 20th National Congress of the CPC clearly points out that "we will implement a national strategy to actively cope with the ageing of the population,develop the elderly care business and the elderly care industry,optimize services for widows and orphans,and promote the realization of basic elderly care services for all elderly people".How to properly mitigate the impact of an ageing population on the economy and society is of great importance in steadily improving the sense of well-being,access and security of the elderly.In terms of theoretical research,this paper firstly compares the relevant theories systematically,and provides theoretical support for this study by exploring the causal relationship between the New Rural Pension System and rural residents’ medical burden;in terms of empirical evidence,based on the relevant hypotheses in the previous paper,the 2018 data from the CHARLS database is used as the research sample,and a fuzzy breakpoint regression model is used to analyse the impact of the new rural insurance pension on rural residents’ medical burden.The sample data were regressed according to different income levels and different health states.In addition,the "Income Effect" and "Crowding Out Effect" generated by receiving pension income were fully considered,and the changes in labour force participation of the sample before and after receiving pension were explored;in the robustness test,firstly,the control variables were used as the antecedent variables to exclude the influence of the control variables on the empirical results.Secondly,the breakpoint regression design avoids the effect of endogeneity on the empirical results to a certain extent,but pensioners are self-selective in terms of access to health care,so in order to further verify that the empirical results are not influenced by selection and endogeneity issues,the robustness test is conducted through the Heckman two-step method,and the inverse Mills ratio is added to the set of control variables for quadratic regressions and found that the empirical results remained robust.The innovations of this paper are the following two:First,it is based on Fuzzy Regression Discontinuity to study the impact of NPS in alleviating the health care burden of rural residents,effectively avoiding the impact of endogeneity problems on the empirical robustness.Second,the perspective of the selected topic is relatively novel.In the existing literature,there is a wealth of articles on the analysis of the effects of NPS policies,but few scholars have included NPS and health care burden levels in the same framework for research.Therefore,this paper further enriches the research perspective of NRPS.更多还原