《保险研究》20190607-《“以医促养”还是“以养促养”:医疗保险与养老金的健康绩效比较》（阳义南、肖建华）

［摘   要］CLHLS 2014年数据的结构方程模型估计结果显示,养老金收入能显著提高老年人的主观健康,并且主观健康还能显著增进生理健康。路径模型进一步检验发现养老金能通过显著改善受访者的居住条件、水果摄入量、及时就医、经济状况等途径来提高老年人的生理健康。而医疗保险支出与老年人主观健康、生理健康之间都呈显著负相关关系。相比医疗保险支出,养老金能带来更正面更积极的健康绩效,且促进老年人健康的途径更为丰富。实证结果说明,相比“以医促养”，“以养促养”的老年人健康绩效更优。本文建议我国从以疾病治疗为中心转为依托养老金购买养老服务,提高老年人生活质量的健康保障体系。

［关键词］养老金；医疗保险；老年人健康；结构方程模型；医养结合

［作者简介］阳义南,华南理工大学教授、博士生导师,管理学博士、经济学博士后,研究方向:社会保障与保险、老年经济学,E-mail:yangynan@scut.edu.cn；肖建华,华南理工大学公共管理学院硕士研究生。

Medical Treatment or Pension:A Comparison of Medical Insurance and Pension ’s Health Performance for Elderly

YANG Yi-nan,XIAO Jian-hua

Abstract：The structural equation model estimates based on CLHLS 2014 data shows that pension income can significantly improve the subjective health of the elderly,while subjective health can further significantly improve physical health.Further tests of the path model show that pension can significantly improve the living conditions,fruit intake,seeking medical advice timely,etc.of the respondents to improve the health of the elderly.There is a significant negative correlation between medical insurance expenditure and subjective health and physical health of the elderly.Compared with medical insurance expenditure,pension can bring more positive and constructive health output,and there are more ways to promote good health of the elderly.The empirical results show that in comparison with the concept of “promoting good health through medical insurance”,the concept of “promoting good health through pension” has a better effect on the health of the elderly.The paper suggests that China should shift from focusing on disease treatment to purchasing elderly care services with pension funds so that the health security system for the elderly is based on better quality of life.

Key words：pension;medical insurance;health of the elderly;structural equation model;combination of medical treatment and life maintenance