- 學位論文
全民健保對家戶預防性儲蓄之排擠效果： Difference-in-Differences模型分析
The Crowd-outs of National Health Insurance on the Household’s Precautionary Saving: Analysis under Difference-in-Differences Model
摘要
摘要 古人有云「貧病相依」。在早期的社會裡，貧窮和疾病兩者是高度相關。對於一個沒有健康保險的家戶來說，若突然發生嚴重疾病所造成的巨大醫療支出，就很可能導致家庭財務上的困難，造成貧窮的後果。而社會健康保險的推動，就是在減少貧窮和疾病之間的相關性，因此當家戶所面臨未來的不確定性下降，預防性儲蓄（precautionary saving）也可能因此減少。本文的研究目的是以台灣橫跨20年的個體資料，以difference-in-differences 的模型方法，利用控制組與對照組在組內及組間的差異，探討1995年台灣全民健保的實施，對家戶預防性儲蓄的排擠效果（crowd-out effect）。本研究結果顯示，NHI的實施會顯著減少家戶的預防性儲蓄；在長期下，健康保險的引進所造成的排擠效果比短期更為顯著。此外，戶長年齡較大和所得較低分組的家戶，在NHI實施後，預防性儲蓄的排擠效果最大。
並列摘要
Abstract Illness and indigence are closely related. For the household without health insurance, a catastrophic illness might induce financial distress and result in poverty. The implementation of National Health Insurance (NHI) is an attempt to diminish the close link between illness and indigence. By reducing the risks of uncertain medical care expenditure, the NHI might lead to lower household precautionary saving. The purpose of this study is to estimate the crowd-out effect which the implementation of NHI has on precautionary savings of the household. This study uses the difference-in-differences model to estimate the treatment effects of NHI, which implemented in 1995, on household savings over the period from 1985 to 2005. The empirical results depict that health insurance significantly dampens household savings. The crowd-out effects became larger as the time progresses. Furthermore, the households with older head or lower incomes become less prudent as they have presented a larger reduction in savings.