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Demand for social health insurance: Evidence from the Chinese New Rural Cooperative Medical Scheme

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  • Yang, Miaoqing

Abstract

This paper assesses the determinants of the enrolment in the New Rural Cooperative Medical Scheme (NRCMS), a heavily subsidized voluntary health insurance scheme in rural China. The analyses focus on the relationship between insurance purchase and health facility choice based on data drawn from the China Health and Nutrition Survey (CHNS). The results show that households from villages that reported use of village clinics are more likely to be insured compared with households from villages that reported use of county hospitals. The results indicate that the perception of quality of care is an important factor affecting people's enrolment decisions. The NRCMS is expected to help patients obtain better quality health services from higher-tier of the healthcare system that are unaffordable otherwise. However, given the prevailing fee-for-service payment mechanism for health care, the insurance may also drive up the healthcare cost and direct patients to use more expensive and unnecessary hospital care.

Suggested Citation

  • Yang, Miaoqing, 2018. "Demand for social health insurance: Evidence from the Chinese New Rural Cooperative Medical Scheme," China Economic Review, Elsevier, vol. 52(C), pages 126-135.
  • Handle: RePEc:eee:chieco:v:52:y:2018:i:c:p:126-135
    DOI: 10.1016/j.chieco.2018.06.004
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    1. Xiaoyun Sun & Sukhan Jackson & Gordon Carmichael & Adrian C. Sleigh, 2009. "Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 103-119, January.
    2. Yu, Hao, 2015. "Universal health insurance coverage for 1.3 billion people: What accounts for China's success?," Health Policy, Elsevier, vol. 119(9), pages 1145-1152.
    3. Wang, Hong & Zhang, Licheng & Yip, Winnie & Hsiao, William, 2006. "Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China," Social Science & Medicine, Elsevier, vol. 63(5), pages 1236-1245, September.
    4. Liu, Dan & Tsegai, Daniel W., 2011. "The New Cooperative Medical Scheme (NCMS) and its implications for access to health care and medical expenditure: Evidence from rural China," Discussion Papers 116746, University of Bonn, Center for Development Research (ZEF).
    5. Lu, Fangwen, 2014. "Insurance coverage and agency problems in doctor prescriptions: Evidence from a field experiment in China," Journal of Development Economics, Elsevier, vol. 106(C), pages 156-167.
    6. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    7. Bhattacharyya, Onil & Delu, Yin & Wong, Sabrina T. & Bowen, Chen, 2011. "Evolution of primary care in China 1997-2009," Health Policy, Elsevier, vol. 100(2-3), pages 174-180, May.
    8. Liu, Hong & Sun, Qi & Zhao, Zhong, 2014. "Social learning and health insurance enrollment: Evidence from China's New Cooperative Medical Scheme," Journal of Economic Behavior & Organization, Elsevier, vol. 97(C), pages 84-102.
    9. Zhang, Licheng & Wang, Hong & Wang, Lushang & Hsiao, William, 2006. "Social capital and farmer's willingness-to-join a newly established community-based health insurance in rural China," Health Policy, Elsevier, vol. 76(2), pages 233-242, April.
    10. Nguyen, Ha & Knowles, James, 2010. "Demand for voluntary health insurance in developing countries: The case of Vietnam's school-age children and adolescent student health insurance program," Social Science & Medicine, Elsevier, vol. 71(12), pages 2074-2082, December.
    11. Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.
    12. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    13. Yang, Yansui & Yang, Dan, 2009. "Community health service centers in China, not always trusted by the populations they serve?," China Economic Review, Elsevier, vol. 20(4), pages 620-624, December.
    14. Sepehri, Ardeshir & Sarma, Sisira & Serieux, John, 2009. "Who is giving up the free lunch? The insured patients' decision to access health insurance benefits and its determinants: Evidence from a low-income country," Health Policy, Elsevier, vol. 92(2-3), pages 250-258, October.
    15. Jones-Smith, Jessica C. & Popkin, Barry M., 2010. "Understanding community context and adult health changes in China: Development of an urbanicity scale," Social Science & Medicine, Elsevier, vol. 71(8), pages 1436-1446, October.
    16. Adam Wagstaff & Magnus Lindelow & Shiyong Wang & Shuo Zhang, 2009. "Reforming China's Rural Health System," World Bank Publications - Books, The World Bank Group, number 2646, December.
    17. repec:bla:glopol:v:8:y:2017:i::p:110-116 is not listed on IDEAS
    18. Panos Kanavos & Olivier Wouters & Wei Yang & Xun Wu, 2017. "Providing Comprehensive Health Insurance Coverage in Rural China: a Critical Appraisal of the New Cooperative Medical Scheme and Ways Forward," Global Policy, London School of Economics and Political Science, vol. 8(s2), pages 110-116, March.
    19. Bhattacharyya, Onil & Delu, Yin & Wong, Sabrina T. & Bowen, Chen, 2011. "Evolution of primary care in China 1997–2009," Health Policy, Elsevier, vol. 100(2), pages 174-180.
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    Cited by:

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    2. Xiaojuan Shen & Weixin Yang & Shaorong Sun, 2019. "Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai," Sustainability, MDPI, vol. 11(23), pages 1-26, November.
    3. Colin Green & Bruce Hollingsworth & Miaoqing Yang, 2021. "The impact of social health insurance on rural populations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 473-483, April.
    4. 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.
    5. Gabriela Mihaela Mure?an & Cristian Mihai Dragos & Codru?a Mare & Simona Laura Dragos & Alexandra Pintea, 2021. "Socio-Economic and Macro-Financial Determinants and Spatial Effects on European Private Health Insurance Markets," The AMFITEATRU ECONOMIC journal, Academy of Economic Studies - Bucharest, Romania, vol. 23(56), pages 290-290, February.

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    More about this item

    Keywords

    Social health insurance; China; Health facility choice; Quality of care;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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