城市贫困救助的福利政策研究

【作者】 曲大维；

【导师】 梁鸿；

【作者基本信息】 复旦大学 ， 人口、资源与环境经济学， 2008， 博士

【摘要】 随着中国改革开放与社会经济的快速发展,以及社会快速转型和贫富差距不断扩大,中国不可避免地出现了城市“新贫困群体”。中国政府高度重视城市贫困问题,并着手通过财政投入、技术发展、基础建设、就业促进等方面做出了一系列制度性安排,构建了中国反贫困政策体系。其中,一项重要的制度性安排就是建立了中国城市社会救助制度。相对于其他反贫困政策而言,贫困救助制度是直接作用于微观贫困家庭的干预政策,其政策目标是如何有效保障已经发生贫困的家庭的基本生存条件以及如何帮助有条件家庭逐步摆脱贫困。本文试图解析贫困发生的微观机制及其政策干预逻辑,并以此作为分析和评述中国城市贫困救助制度的基础。本文在贫困调查分析的基础上,以公平与效率为价值判断尺度,通过贫困家庭的需求与贫困救助政策供给的均衡状况考察,分析和评价中国的贫困救助政策的实施成效,并提出进一步完善的相关政策建议。全文分为十章:第一章,问题的提出。在文献综述的基础上,提出了本文需要研究的命题:贫困发生的微观机制及其贫困救助政策逻辑是什么?家庭的贫困家庭的特征及其内在的结构变化,目前呈现的是怎样的一种水平?这种变化在多大程度上,作为贫困救助政策的实施基础,影响着贫困救助政策的成效?贫困救助政策的实施,是否满足了贫困家庭的需求?随着中国社会经济的发展,中国贫困救助体系和救助政策,如何能够适应形势的变化,从而完善政策理念、政策目标以及救助政策体系?本文利用上海市城市居民生活状况调查以及浦东新区贫困动态调查数据,以及相关资料,进行了实证研究。第二章,贫困发生的微观机制及其政策干预的逻辑。贫困发生的关键在于个人发展能力的缺失。这种发展能力的缺失除了来自于宏观环境和因素影响以外,,另一个重要的方面在于微观的个人家庭层面,即生存条件、教育资本、健康资本、就业机会和生活环境。贫困救助制度是针对已经发生贫困家庭实施有效保障和援助的一项制度,因此,贫困发生的微观机制是贫困救助制度实施的理论基础,也是贫困救助政策干预的逻辑起点。针对贫困家庭发生的机制及其最主要因素而建立的分类社会救助政策,具有内在的逻辑联系。实现政策目标的最优化,在于确定政策所针对干预因素所表现矛盾的冲突性及控制贫困恶性循环的作用贡献。由于这些因素可能是交互影响的。因此,救助政策有效性还取决于救助政策体系的完备性和结构的协调性。此外,政策的有效性将在很大程度上取决于政策设计和政策执行。政策的有效性,需要在需求、利用与政策干预的互动界面进行考察。这一方面依赖于对贫困发生机制及其需求特征的收入分析;另一方面,依赖于政策目标是否与主要需求相吻合,以及政策目标实现程度及其贡献的科学评价。第三章,贫困人口的特征及其政策干预基础。本章在贫困家庭的人口学特征,贫困家庭与一般家庭生活状况的比较以及贫困人口的脱贫和返贫这三个方面进行了分析。导致贫困的原因是快速社会发展和社会转型中,个人能力发展的缺失,贫困的风险具有普遍的社会化倾向。中国贫困救助已成为保障全体社会成员抗拒社会变迁而导致生活风险的最基本的制度。贫困家庭与一般家庭在劳动力资源拥有量、就业能力、收入水平和收入结构、消费水平和消费结构、负债、居住条件、健康状况等方面有明显差距,贫困家庭在面对生活风险时具有脆弱性的特点,即使短期内实现脱贫,此后仍然面临着很大的风险跌回贫困陷阱。政策干预应重点集中在为贫困家庭创造更多的就业机会和医疗服务的公平性和可及性上。第四章,贫困人口基本生活满足程度与生活救助。本章研究了贫困家庭基本生活状况方面的一般特征及最低生活保障制度供给的特征表现。研究结果表明,在最低生保保障制度覆盖后,贫困家庭的基本生活已经得到了较为有效地解决。制度面临的最大挑战,是如何能够帮助贫困家庭有效的发展个人的能力,从而克服发展能力的缺失。同时,贫困家庭基本生活也面临着医疗、教育等多种风险,由于贫困微观机制各个因素之间存在着相互交织的影响,单一的最低生活保障制度本身并不足以应对除基本生活之外的其他风险,需要建立一个复合型的综合社会救助,实现其政策效用最大化。第五章,贫困人口教育获得性与公平性及其教育救助。本章分析了贫困家庭教育状况的一般性特征以及教育救助供给状况的特征表现。研究表明,教育资本的缺失是导致贫困的重要因素,尤其是贫困家庭的子女教育处于弱势的状况是显而易见的。尽管贫困教育救助制度的实施,在很大程度上改变了贫困家庭子女教育的可获得性和公平性,但是,又面临着一个新的发展陷阱,即“高投入低产出”的“教育陷阱”。今天的贫困教育救助政策可能面临着两难的选择,从有限的救助目标而言,提高其教育的可获得性和公平性是适宜的,但是从打破贫困的恶性循环,获得高教育资本,进而获得高收入,并走出贫困的良性循环而言,其实际的成效是十分有限的。将贫困教育救助制度适度的延伸是需要的。第六章,贫困人口住房环境改善及其住房救助。本章研究贫困家庭住房环境的特征和廉租房制度供给状况,研究结果表明,贫困家庭确实存在着居住环境恶劣的状况,但这种状况并不是在所有贫困家庭都存在,从某种意义上讲,存在住房困难的贫困家庭,事实上是贫困家庭中的最赤贫者。他们走出贫困或摆脱贫困的障碍可能更大。廉租房制度的实施,对缓解贫困者的住房困难起到了一定的作用,但由于受到住房市场供给和政策供给的双重制约,政策的效用发挥受到了一定影响。建立一种混合型的供给方式,或许有助于提高政策的成效。同时,建立一种针对相对贫困者的住房救助制度,将有助于减少贫困的发生。第七章,贫困人口就业机会、影响因素与就业促进。本章研究了贫困家庭的就业机会及其影响因素,研究结果表明,由于个人发展能力的缺失,贫困家庭的就业机会与就业状况要明显低于一般家庭,即使存在着就业,由于个人的能力因素,也往往得到的是低收入。为贫困人口提供就业培训,提高技能,对于促进贫困家庭的就业,固然是十分重要的。但是,由于贫困发生机制各因素之间交互作用的影响,单一的技能培训,并不能达到就业促进的目标,因为贫困就业机会的缺失往往伴随着健康程度差等状况。因此,必须采取综合的救助政策,才能最大化的实现就业促进的目标。第八章,贫困人口医疗服务的公平性、可及性与医疗救助。本章研究了贫困家庭健康状况及其影响因素,以及医疗救助制度供给的特征表现,研究结果表明,贫困家庭的健康状况明显比一般家庭差。在贫困家庭基本生活得到保障的情况下,贫困人口的医疗服务成为影响贫困恶性循环的一个最重要的因素。贫困人口医疗服务可及性的严重障碍,不仅影响其健康状况,也同时影响着其它方面的改善。健康对就业的影响以及因病致贫、因病返贫都是当前最突出的矛盾。贫困医疗救助制度的实施,对于减轻贫困人口疾病经济的负担,起到了一定的作用,并间接的提高了贫困人口医疗服务的利用程度。但是,从贫困人口医疗服务需求特征以及公共财政的承受能力出发,贫困医疗救助的政策目标应更加着力于提高贫困人口医疗服务的公平性和可及性。第九章,贫困救助制度与体系完善:以医疗救助为例。本章在分析当前贫困医疗救助政策与实践的基础上,比较了当前中国城市贫困医疗救助的几种主要的模式,提出贫困医疗救助政策理念需要从减轻患病贫困家庭的经济负担扩展为提高贫困人口的医疗服务的公平性和可及性;从“大病救济”理念扩展为医疗救助要对贫困人口基本的医疗权利起基础性保障作用;从贫困救助基金的“收支平衡”扩展为“社会福利效益最大化”,形成“低水平、广覆盖、广收益”的政策理念,基本医疗与“大病风险”相融合的综合医疗救助模式,从“大病救助”的末端治理,扩展为从基础性改善贫困人口的基本医疗与健康状况;从贫困医疗的关怀式救助拓展为以增进和改善健康和能力为目标的“发展式”救助;从事后的消极救助方式拓展为事前和事中的积极救助方式。并以此为理论基础,设计了以社区卫生服务为基础的贫困医疗救助模式。第十章,城市化进程中的城乡社会救助的结构性完善。随着中国城市化进程不断加剧,有相当一部分农民已经丧失了土地而成为事实上的城市居民。但是由于其能力无法适应城市经济发展的要求而陷入贫困。这已成为当前城市化进程中面临的一个十分严峻的社会问题。另一方面,由于城乡二元结构的存在,二元社会救助政策城乡间显著的待遇差别及其引起的社会公正损失,对社会救助的整体效应产生了不利的影响。但是,城乡二元结构的消除还需要一个相当长的历史过程。本章针对如何渐进地打破城乡二元社会救助体系,进一步完善社会救助体系结构,提高社会救助的整体效用,提出了阶梯式的渐进融合过程,即构建低保人群覆盖面的阶梯、构建低保标准的阶梯和构建低保内容的阶梯。更多还原

【Abstract】 The new poverty colony has emerged since China’s embarking on the path of reform and opening-up, the rapid development of the social economy, the rapid social transformation and the expanding of the income disparity. The government has paid much attention to the urban poverty, and has made a series of institutional arrangements on the financial input, technological development, basis construction and the employment promotion, etc, to construct an anti-poverty policy system. Among these institutional arrangements, a most important one is the Urban Social Relief System. Compared to other anti-poverty policies, the Urban Social Relief System is a direct intervention to the micro-mechanism of poor families. This policy aims to effectively secure the basic living conditions of the poor families and help some families escape from poverty.This dissertation attempts to analyze the micro mechanism of the poverty emergence and the logic of the policy intervention, and comment the basic of the China Urban Social Relief System. Based on the investigation data analysis, taking equity and efficiency as the judging yardstick, according to the equilibrium of the demand of poor families and the policy supply, this dissertation evaluated the implement efficiency of the China Urban Social Relief System and made suggestions on perfecting the system.This dissertation is built up with ten chapters:The first chapter is the raise of the issue. On the basis of literature review, the author raised the issue of this dissertation. It includes the following questions: What is the micro mechanism of the emergence of poverty and the logic of the Social Relief System? What are the feature and the present level and the inner structure changes of the poor families? How and to what degree did the changes influence the effect of the Urban Social Relief System as an implement basis? Has the implement of the Urban Social Relief System satisfied the demand of the poor families? How can the Urban Social Relief System adapt to the change of the environment and perfect its policy ideology and policy aim with the social economic development? The author then introduced the investigation data and some correlative data. The second chapter is the micro mechanism of the emergence of poverty and the logic of the policy intervention. The most important reason of the emergence of poverty is the absence of the personal development capability. The absence of the personal development capability is influenced by not only the macro environment and factors but also the micro lay of individual family. The micro factors are: living conditions, education capitals, health capitals, employment opportunity and the living environment. The Urban Social Relief System is aimed to secure the already-in-poor families, so the micro mechanism of the emergence of poverty is the theoretical basis and the logical jumping-off point of the Urban Social Relief System. There exists inner logical relation between the poverty emergence mechanism and the sorted Social Relief System. The optimization of the implement of the policy aim lies in the confirmation of the conflict of the factors and the contribution on the control of the vicious circle of poverty. Because of the commutative influence of the factors, the efficiency of the policy lies on the policy design and the policy implement. It is necessary to investigate on the interaction interface of the demand, the supply and the policy intervention to achieve the efficiency of the policy. It lies on one hand the analysis of the emergence mechanism of poverty and the income analysis of the demand feature, on the other hand the accordance between the policy aim and the demand and the implement extent.The third chapter is the feature of the poor population and the basis of the policy intervention. The author analyzed in the following aspects: the demographic feature of the poor family, the comparison of the living conditions of the poor families and the non-poor families, the escape from poverty and the return into poverty. The reason of getting into poverty is the absence of personal development capability. The risk of poverty shows a socialized tendency. The Urban Social Relief System has become the primary institution to secure total society against the living risk. The disparity exists between poor families and the non-poor families on the labor force capital, employment capability, income level, income structure, consumption level, consumption structure, debt, habitation, health status, etc. The poor families have feature of fragility that they will face risk of return into poverty even they can escape poverty in short period. The policy intervention must focus on the creation of more employment opportunity and the equity and availability of the medical service.The fourth chapter is the satisfaction degree of the basic living of poor families and the living aid. This chapter studied the feature of the basic living conditions of the poor families and the supply of the Urban Social Relief System. The result of the study shows that after the implement of the minimus-income security system, the basic living of the poor family is satisfied. The biggest challenge to the system is how to help the poor families to effectively develop their capability. Meanwhile, the poor families face the medical and educational risk also, and the factors influence each other, so the single minimus-income security system is not able to resolve all the risks except the basic living. A synthetical social aid system must be established in order to achieve the maximization of the policy utility.The fifth chapter is the obtainability and the equity of the education of poor families and the educational aid. The author analyzed the feature of the education conditions of the poor families and the supply of the education aid system. The study shows that the absence of educational capital is an important factor to leading into poverty. The implement of education aid system improve the obtainability and the equity of the poor families, but they will face a high-input-low-output poverty trap, too. The present education aid system may face a dilemma: from aspect of the limit education aim, it is reasonable to improve the obtainability and the equity of education, but from the aspect of breaking poverty trap, obtaining high education capital and high income, the effect is very limited. It is necessary to expand the poverty education aid system.The sixth chapter is the improvement of the poor families’ habitation environment and the housing aid. This chapter studied the feature of the poor families’ habitation environment and the supply of the low-rent house system. It shows that the habitation conditions of the poor families is very bad, but not to all poor families. The poor families that have difficulty in the habitation conditions in fact are the most poor families. Their difficulty to escape poverty is much higher. The implement of the low-rent house system helped the poor families much, but the policy’s effect was weakened because of the dual restrict of the housing market supply and the policy supply. It can help improve the policy effect to establish a new complex supply mode which aims to the relative poor families.The seventh chapter is the employment opportunity and its influence factors and the employment promoting. This chapter studied the poor families’ employment status and its influence factors. The results show that because of the absence of personal development capability, the poor families’ employment opportunity and income is much lower than the non-poor families. It is important to offer the poor more employment training and improve their skills, but the single skill training can not achieve the aim of employment promoting because of the interaction of the factors that cause poverty. It is necessary to establish a synthetic aid policy system in order to maximize the policy effect of employment promoting.The eighth chapter is the equity, availability of the medical service to poor families and the medic aid. This chapter studied the health status and its influence factors of the poor families and the supply of the medic aid system. The result shows that the poor families’ health status is much worse than the non-poor families. After the basic living demand was satisfied, the medical service has become a very important factor which influences the vicious circle of poverty. The severe obstacle in the availability of the medical service to poor families not only influences the poor people’s health status but also influences improvement on other aspects. The influence of health to employment and the getting into poverty or returning into poverty because of illness, has become the most severe conflict. The medic aid system has helped to alleviate the poor people’s illness burden and improved the utilization degree of the medical service. But, the poverty medic aid system must focus more on the improvement of the equity, availability of the medical service to poor families, because of the feature of the poor families medical service demand and the capability of the public finance.The ninth chapter is the perfecting of the Urban Social Relief System. This chapter takes medic aid as the example. The author analyzed the primary modes of present medic aid system and argued that the policy ideology must change from alleviate the medical burden of the poor families to improve the equity, availability of the medical service to poor families, from "severe illness aid" to basic security to medical rights of the poor people, from the financial equilibrium to the maximization of the social utility. A synthetical medic aid mode must be established that is "low level, abroad coverage and abroad proceed" and consists of both basic medical service and severe illness service. The author designed a medic aid system which is based on the Community Health Service.The tenth chapter is the structure perfecting of the Urban-Rural Social Relief System in the urbanization course. It has become a severe problem that in the urbanization course, some peasants lost their ground and turned to the urban poor. On the other side, the obvious disparity between urban and rural social relief system exists, it damaged the social equity and had disadvantage influence to the whole Social Relief System. The author designed a ladder path to combine the urban and rural Social Relief System which consists of constructing the beneficiary coverage ladder, constructing the subsidy criterion ladder and the security content ladder.更多还原