Abstract：The concept of family and the tradition of kinship are deeply rooted in the social structure and values of our country, and mutual assistance, support and care between blood relatives are regarded as the basic responsibilities and obligations of the family and society. The functional similarity between blood relatives and the formal insurance system makes it possible for blood relatives to substitute for commercial health insurance, which in turn affects its development to a certain extent. The construction and improvement of the formal insurance system requires a long and lengthy process, and blood relatives are of great significance to the establishment of a multi-level social security system. From the perspective of blood relative support, this study utilizes the latest data from the China Household Finance Survey to conduct an empirical study on the linkage between blood relative support, an informal security system considered to be very important in rural areas, and commercial health insurance, a formal system, and to explore the impact of blood relative support on the breadth and depth of participation in commercial health insurance for households. The results of the benchmark regression show that kinship support has a “substitution effect” on commercial health insurance, that kinship support inhibits the participation of families in commercial health insurance, and that families with a higher degree of kinship support are less likely to purchase commercial health insurance and spend less on premiums. The results remain significant after supplementing the control variables, adjusting the sample domain and considering the endogeneity issue. Path analysis suggests that there is a crowding-out effect of blood kinship that inhibits household commercial health insurance participation by reducing the risk of catastrophic medical expenditures. Financial literacy plays a moderating role in the process of family blood kinship crowding out commercial health insurance participation, and can effectively mitigate the inhibitory effect of family blood kinship on commercial health insurance development. In the heterogeneity analysis, blood relatives have a significant crowding-out effect on the commercial health insurance participation behavior of families in the low-education group, the risk-averse group and the risk-neutral group. This study contributes to the research on the impact of the informal insurance system on the formal insurance system. Based on traditional Chinese culture, this study analyzes the specific impact on the breadth and depth of family commercial health insurance participation from the perspective of blood relatives, which enriches the research on the impact of the informal insurance system on the formal insurance system, contributes to an in-depth understanding of the reasons for the low demand for family commercial health insurance, and reveals the cultural factors behind the phenomenon of limited participation in commercial health insurance, which is of important theoretical value and practical significance. Unlike previous scholars who utilized a single variable to measure clan and kinship, this study integrates multiple transfer income and expenditure indicators to construct a more specific concept of blood relatives, which is more comprehensive. Additionally, this study not only explores the intrinsic link between blood kinship and family commercial health insurance participation but also reveals the causal path of blood kinship in reducing family commercial health insurance participation by reducing the risk of catastrophic medical expenditures, which enriches and expands the related research on the formal insurance system and provides more perspectives for helping the high-quality development of China’s commercial health insurance market and responding to healthcare problems.
出版日期: 2025-01-24
引用本文:
张少军 严佳慧 杨泽江 刘诗梅. 血亲相济与家庭健康保险参与[J]. 浙江大学学报(人文社会科学版), 0, (): 1-.
Zhang Shaojun Yan Jiahui Yang Zejiang Liu Shimei. . JOURNAL OF ZHEJIANG UNIVERSITY, 0, (): 1-.
