关键词: 收入不平等, 药品零加成, 相对价格变化, 病情, 医疗支出

Abstract: This paper focuses on how zero markup reform changes the allocation of medical expenditure among different diseasesIn the first place, this paper uses four waves of the China Health and Retirement Longitudinal Study (CHARLS) data to conduct a differenceindifference analysis to identify the redistribution effect of medical expenditure allocation among different diseasesThe results show that, after the reform, a tenpercent rise in regional drug sale reliance will make the medical expenditure of an average patient increase by 513%However, a onestandard deviation increase in the patient's severity will make the increase of his total expenditure decrease by 298%Secondly, this paper discusses and tests empirically the possible causes of this phenomenon under the framework of twodimensional heterogeneity in income and severityThe paper shows that the zeromarkup reform increases the relative price of treatments that are more suitable for severe conditions and therefore encourages physicians to overuse themHowever, the usage of these treatments is quite different among patients with different income levelsHighincome patients with milder conditions are more likely to use them, but lowincome patients with more severe conditions are relatively less likely to use themThis micro mechanism leads to the misallocation of medical resources among different conditions

Key words: income inequality, zero markup reform, relative price change, severity of diseases, medical expenditure