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Does participating in health insurance benefit the migrant workers in China? An empirical investigation

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  • Qin, Xuezheng
  • Pan, Jay
  • Liu, Gordon G.

Abstract

Rural-to-urban migrant workers are an under-represented group in China's health insurance system, and the status of their health and healthcare draws increasing attention. This paper uses the 2007–2010 State Council URBMI Household Survey data to evaluate the efficacy of major health insurance programs in improving the accessibility, affordability and appropriateness of healthcare among migrant workers. Based on the instrumental variable (IV) estimation that accounts for the endogeneity of insurance participation, we find that the Urban Employee Basic Medical Insurance (UEBMI) is most effective in promoting physical exams and improving self-rated health status for migrant workers, while the New Rural Cooperative Medical Scheme (NRCMS), the Urban Resident Basic Medical Insurance (URBMI) and commercial insurance show significant benefits in boosting preventive care utilization. However, the current programs are not effective in alleviating the financial burden of healthcare and promoting formal medical utilization among migrant workers, possibly due to the lack of systematic financing scheme for outpatient treatment and the segmentation between insurance platforms. Our study provides implications on reforming China's medical insurance system and migrant health policies.

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  • Qin, Xuezheng & Pan, Jay & Liu, Gordon G., 2014. "Does participating in health insurance benefit the migrant workers in China? An empirical investigation," China Economic Review, Elsevier, vol. 30(C), pages 263-278.
    • Handle: RePEc:eee:chieco:v:30:y:2014:i:c:p:263-278
    DOI: 10.1016/j.chieco.2014.07.009
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    2. Fei Zhang & Xinjie Shi & Yun Zhou, 2020. "The Impact of Health Insurance on Healthcare Utilization by Migrant Workers in China," IJERPH, MDPI, vol. 17(6), pages 1-14, March.
    3. Zhang, Anwen & Nikoloski, Zlatko & Mossialos, Elias, 2017. "Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly," Social Science & Medicine, Elsevier, vol. 190(C), pages 11-19.
    4. Wang, Yijie & Shi, Julie & Yao, Yi & Sun, Wenkai, 2022. "The impact of health insurance on job location choice: Evidence from rural China," Journal of Comparative Economics, Elsevier, vol. 50(2), pages 569-583.
    5. Shenghua Xie & Juan Chen & Veli-Matti Ritakallio & Xiangming Leng, 2021. "Welfare migration or migrant selection? Social insurance participation and rural migrants’ intentions to seek permanent urban settlement in China," Urban Studies, Urban Studies Journal Limited, vol. 58(10), pages 1983-2003, August.
    6. Chen, Yu & Huang, Feng & Zhou, Qin, 2023. "Equality of public health service and family doctor contract service utilisation among migrants in China," Social Science & Medicine, Elsevier, vol. 333(C).
    7. Bai, Y. & Wang, W. & Zhang, L., 2018. "How long do returning migrants stay in their home county: Evidence from rural China during 1998 to 2015," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 277380, International Association of Agricultural Economists.
    8. Yunli Bai & Weidong Wang & Linxiu Zhang, 2018. "How Long Do Return Migrants Stay in Their Home Counties? Trends and Causes," Sustainability, MDPI, vol. 10(11), pages 1-21, November.
    9. Tianyuan Luo & Cesar L. Escalante, 2020. "Public Health Insurance and Farm Labor Supply: Evidence from China's Rural Health Insurance Reform," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 28(6), pages 101-124, November.
    10. Tong, Michael Xiaoliang & Hansen, Alana & Hanson-Easey, Scott & Xiang, Jianjun & Cameron, Scott & Liu, Qiyong & Liu, Xiaobo & Sun, Yehuan & Weinstein, Philip & Han, Gil-Soo & Bi, Peng, 2018. "China's capacity of hospitals to deal with infectious diseases in the context of climate change," Social Science & Medicine, Elsevier, vol. 206(C), pages 60-66.
    11. Cui, Kun & Li, Bo & Wang, Hanyang, 2021. "Quantitative analysis of health insurance reform in China: Pure consolidation or universal health insurance?," Economic Modelling, Elsevier, vol. 101(C).
    12. Runguo Wu & Niying Li & Angelo Ercia, 2020. "The Effects of Private Health Insurance on Universal Health Coverage Objectives in China: A Systematic Literature Review," IJERPH, MDPI, vol. 17(6), pages 1-21, March.
    13. Fei Xie & Xiaoqing Jiang & Fang Yuan & Xiaoyun Chen & Zhaokang Yuan & Yuanan Lu, 2018. "Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China," IJERPH, MDPI, vol. 15(7), pages 1-11, June.
    14. Qing Yang & Qing Xu & Yufeng Lu & Jin Liu, 2020. "The Impact of Public Health Insurance on Household Credit Availability in Rural China: Evidence from NRCMS," IJERPH, MDPI, vol. 17(18), pages 1-17, September.
    15. Lin Gong & Juan Chen, 2023. "Disparities in Social Insurance Participation and Urban Identification Among In-situ Urbanized Residents in China," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 18(3), pages 1269-1289, June.
    16. Fu, Minghui & Liu, Chuanjiang & Yang, Mian, 2020. "Effects of public health policies on the health status and medical service utilization of Chinese internal migrants," China Economic Review, Elsevier, vol. 62(C).
    17. Zhang, Shemei & Sun, Zhanli & Ma, Wanglin & Valentinov, Vladislav, 2020. "The effect of cooperative membership on agricultural technology adoption in Sichuan, China," China Economic Review, Elsevier, vol. 62(C).
    18. Rajat Deb & Tapash Paul & Jaharlal Debbarma & Kiran Sankar Chakraborty, 2020. "Breaking the Stigma of Health Insurance," Management and Labour Studies, XLRI Jamshedpur, School of Business Management & Human Resources, vol. 45(1), pages 54-84, February.
    19. Baozhong Su & Gatwaza Hategekimana Thierry & Qihui Chen & Qiran Zhao, 2017. "The New Cooperative Medical Scheme and Self-Employment in Rural China," Sustainability, MDPI, vol. 9(2), pages 1-10, February.
    20. Si Shi & Yawen Jiang, 2022. "Does supplemental private health insurance incentivize household risky financial asset investment? Evidence from the China Household Financial Survey," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 369-421, December.
    21. Wen He, 2022. "Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 7-22, February.
    22. Chen, Yi & Shi, Julie & Zhuang, Castiel Chen, 2019. "Income-dependent impacts of health insurance on medical expenditures: Theory and evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 290-310.
    23. Li, Xiaoxue & Tian, Liu, 2020. "The effect of non-employment-based health insurance program on firm's offering of health insurance: Evidence from the social health insurance system in China," Journal of Comparative Economics, Elsevier, vol. 48(4), pages 997-1010.
    24. Yinzi Jin & Zhiyuan Hou & Donglan Zhang, 2016. "Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-15, August.
    25. R Arthi & R Naagarajan, 2018. "Health Security of Migrant Workers in Tirupur Garment Industry - An Econometric Analysis," Shanlax International Journal of Economics, Shanlax Journals, vol. 6(2), pages 27-43, March.

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    More about this item

    Keywords

    Health insurance; Migrant worker; China;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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