The Impact of Medical Insurance Payment Policy Reform on Medical Cost and Medical Burden in China

Abstract

Medical insurance that pays for the medical expenses of the insured is regarded as being maximally fair, but often leads to the excessive use of medical services, medical expenses rising too rapidly, and the waste of health resources. The deductible and reimbursement ratio defines the part of the cost to be borne by the patient to reduce moral hazard, preventing adverse selection and easing the burden of medical expenses. But will improving the deductible or reducing the reimbursement ratio reduce medical expenses and reduce the medical burden of the insured? By using panel data from 2011 to 2019, this paper examines the effect of the deductible and reimbursement ratio on reducing medical expenses. The following conclusions were obtained: First, the impact of the deductible on medical costs and the medical burden is significant and negative. Specifically, lowering the deductible can reduce medical costs and reduce the medical burden of patients. Second, the impact of the reimbursement ratio on medical expenses and the medical burden is significant and negative, that is, with all other factors remaining equal, an increase in reimbursement ratio will result in a reduction in medical expenses and medical burden. Third, the combined effect of the deductible and reimbursement ratio has a significant impact on both medical expenses and medical burdens. Specifically, changes in the deductible and reimbursement ratio in the same direction can reduce both the medical expenses and the burden on patients. Fourth, based on an analysis in which 31 provinces were divided into economically developed and less developed areas, it was found that the deductible and reimbursement ratio have a certain impact on medical expenses and medical burden; in relatively less developed areas, with increasing per capita GDP, the flow of patients in large hospitals will inevitably increase, and the overall medical expenses will rise.