[1]石 龙,赵盘珍.行为经济学视角下城乡居民医保参保激励的现实困境与优化策略[J].卫生经济研究,2026,43(08):31-34.
　SHI Long,ZHAO Panzhen.Realistic Dilemma and Optimization Strategies of Participation Incentives of Urban and Rural Residents' Medical Insurance from the Perspective of Behavioral Economics[J].Journal Press of Health Economics Research,2026,43(08):31-34.
点击复制

行为经济学视角下城乡居民医保参保激励的现实困境与优化策略

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年08期
页码:
31-34
栏目:
医疗保障
出版日期:
2026-07-30

文章信息/Info

Title:
Realistic Dilemma and Optimization Strategies of Participation Incentives of Urban and Rural Residents' Medical Insurance from the Perspective of Behavioral Economics
作者:
石 龙1; 赵盘珍2
1.右江民族医学院人文与管理学院，广西 百色 533000
2.右江民族医学院语言文化学院，广西 百色 533000
Author(s):
SHI Long;  ZHAO Panzhen
School of Humanities and Management, Youjiang Medical University for Nationalities, Baise Guangxi 533000, China
关键词:
城乡居民医保; 参保激励; 行为经济学理论
Keywords:
urban and rural residents' medical insurance;  participation incentives;  behavioral economics theory
分类号:
R19；F840.684
文献标志码:
A
摘要:
基于行为经济学理论分析，城乡居民医保参保激励面临损失厌恶引致的保费支出与风险保障感知失衡、锚定效应诱发的参保认知偏差、“双曲贴现”导致的即期付费与远期保障决策错配、行为成本约束形成的参保决策壁垒等现实困境。对此，应完善参保激励机制，采取损失缓释与收益显性化、认知锚点重构、跨期利益关联以及行为成本最小化策略，设计契合城乡居民认知机制和心理逻辑的优化策略，解决城乡居民医保“续保难”问题。
Abstract:
Based on behavioral economics theory, the incentive mechanism for participation in urban and rural residents' medical insurance faces practical dilemmas, including the imbalance between premium expenditure and risk perception induced by loss aversion, cognitive biases triggered by the anchoring effect, decision-making mismatches between immediate payment and long-term protection caused by hyperbolic discounting, and barriers to participation decisions formed by behavioral cost constraints. To address these challenges, participation incentive mechanisms should be improved by adopting strategies such as loss mitigation and benefit explicitization, cognitive anchor reconstruction, intertemporal benefit association, and behavioral cost minimization, designing optimization strategies that align with the cognitive mechanisms and psychological logic of urban and rural residents, thereby solving the problem of "difficult renewal" in urban and rural residents' medical insurance.

参考文献/References:

[1] 李珍.基本医疗保险参保机制改革的历史逻辑与实现路径[J].暨南学报（哲学社会科学版），2022，44（11）：69-79.
[2] 朱铭来，胡祁，赵轶群.关于实现基本医疗保险全民参保的若干思考[J].中国卫生经济，2021，40（01）：45-48.
[3] 郑功成，谭琳子.居民医保个人筹资政策：缘起、困境与优化[J].中国农村经济，2024（03）：2-21.
[4] Sai S K, Lyer S I, Sai S B. Insights from behavioral economics for policymakers of choice-based health insurance markets: a scoping review[J]. Risk Management and Insurance Review, 2022, 25(02): 115-143.
[5] Palupi U B. Beyond immediate needs: an analysis of social insurance and its behavioral economic impact in Indonesia[J]. Jurnal Jaminan Kesehatan Nasional, 2024, 4(02): 96-108.
[6] Krishnan S S, Iyer S S, Balaji SMR S. Insights from behavioral economics for policymakers of choice-based health insurance markets: a scoping review[J]. Risk Management and Insurance Review, 2022, 25(02): 115-143.
[7] Wong C A, Polsky D E, Jones A T, et al. For third enrollment period, marketplaces expand decision support tools to assist consumers[J]. Health Affairs, 2016, 35(04): 680-687.
[8] 王俊华，蔡滨.推进全民医保从形式普惠走向实质公平——国外医保模式的启示[J].苏州大学学报（哲学社会科学版），2017，38（05）：41-46.
[9] 王昭茜，仇雨临.逆向选择还是制度“漏洞”：全民医保下的不连续参保行为研究[J].兰州学刊，2021（06）：124-138.
[10] 赵建国，石龙.共同富裕背景下灾难性卫生支出对农户收入不平等的影响[J].财贸研究，2023，34（11）：62-72.
[11] Abdellaoui M, Bleichrodt H, Paraschiv C. Loss aversion under prospect theory: a parameter-free measurement[J]. Management Science, 2007, 53(10): 1659-1674.
[12] Kai-Ineman D, Tversky A. Prospect theory: an analysis of decision under risk[J]. Econometrica, 1979, 47(02): 363-391.
[13] 张璐，李雪.损失厌恶与商业健康保险研究[J].保险研究，2021（10）：36-50.
[14] Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases: biases in judgments reveal some heuristics of thinking under uncertainty[J]. Science, 1974, 185(4157): 1124-1131.
[15] 贺京同，那艺.行为经济学：选择、互动与宏观行为[M].北京：中国人民大学出版社，2025：86-88.
[16] 朱凤梅，王震.城乡居民连续参保决策行为研究——来自医保行政数据的微观证据[J].保险研究，2025（10）：96-111.
[17] Laibson D. Golden eggs and hyperbolic discounting[J]. The Quarterly Journal of Economics, 1997, 112(02): 443-478.
[18] Sunstein C R. Nudging: a very short guide[J]. The Handbook of Privacy Studies, 2014, 37: 583-588.
[19] Barnes A J, Hanoch Y, Rice T, et al. Moving beyond blind men and elephants: providing total estimated annual costs improves health insurance decision making[J]. Medical Care Research and Review, 2017, 74(05): 625-635.
[20] Baicker K, Congdon W J, Mullainathan S. Health insurance coverage and take-up: lessons from behavioral economics[J]. The Milbank Quarterly, 2012, 90(01): 107-134.
[21] Manru L, Jianmin Z, Ziyun G. The interval anchoring effect[J].Experimental Psychology, 2021, 68(06): 295-304.
[22] Serfilippi E, Carter M, Guirkinger C. Insurance contracts when individuals “greatly value” certainty: results from a field experiment in Burkina Faso[J]. Journal of Economic Behavior & Organization, 2020, 180: 731-743.
[23] 高彧，李沁，李显荣，等.基于行为经济学的助推研究：关键要素、应用场景及在中国的政策前景[J].经济学（季刊），2025，25（04）：821-845.
[24] Ketcham J D, Kuminoff N V, Powers C A. Estimating the heterogeneous welfare effects of choice architecture[J]. International Economic Review, 2019, 60(03): 1171-1208.

相似文献/References:

[1]庄 琦.大学生医保现状与改革[J].卫生经济研究,2016,(11):51.
[2]张翠萍.城镇职工医保与城乡居民医保制度整合探析[J].卫生经济研究,2018,(05):60.
[3]付晓光.居民医保待遇调整机制现状及建议[J].卫生经济研究,2019,(05):56.
　FU Xiao-guang.Current Situation and Suggestions on the Adjustment Mechanism of Residents' Medical Insurance Benefits[J].Journal Press of Health Economics Research,2019,(08):56.
[4]张宇微,陈家应,张 兵,等.城乡居民医保整合后医疗服务利用和费用负担变化研究[J].卫生经济研究,2022,39(7):32.
　ZHANG Yuwei,CHEN Jiaying,ZHANG Bing,et al.A Cohort Study on the Changes of Medical Service Utilization and Cost Burden after the Integration of Basic Medical Insurance System for Urban and Rural Residents[J].Journal Press of Health Economics Research,2022,39(08):32.
[5]谭华伟,陈迎春.紧密型县域医共体对医保患者住院成本分担的效应研究 ——基于双重差分法的实证经验[J].卫生经济研究,2023,40(8):45.
　TAN Huawei,CHEN Yingchun.Study on the Effects of Compact County-level Medical Community Reform on Hospitalization Cost-sharing for Medical Insurance Patients ——Empirical Experience based on Double Difference Method[J].Journal Press of Health Economics Research,2023,40(08):45.
[6]王 鉴,黄成庆,张 云,等.不同医保类型患者住院费用和补偿水平的比较分析[J].卫生经济研究,2023,40(10):45.
　WANG Jian,HUANG Chengqing,ZHANG Yun,et al.Comparative Analysis of Hospitalization Expenses and Compensation Levels for Patients with Different Types of Medical Insurance[J].Journal Press of Health Economics Research,2023,40(08):45.

更新日期/Last Update: 2026-07-30