IDEAS home Printed from https://ideas.repec.org/a/eee/labeco/v67y2020ics0927537120301354.html
   My bibliography  Save this article

Locked out? China’s health insurance scheme and internal migration

Author

Listed:
  • Shi, Xuezhu

Abstract

Providing health insurance with certain geographical restrictions may lead to misallocations in the labour market by hindering migration. This paper tests whether the rural health insurance first introduced in 2003, the New Cooperative Medical Scheme (NCMS), had unintended and negative effects on rural-to-urban migration mobility in China. The NCMS offers health insurance only to people with rural household registration, and they can benefit from the NCMS only when visiting the hospitals near their registered location in the household registration system. An event-study approach to a new dataset collected from provincial yearbooks in China reveals at the county level that the NCMS reduces the percentage and rate of growth of the percentage of rural residents who are rural-to-urban migrants and who work outside their home county. Using the China Health and Nutrition Survey (CHNS), my instrumental variable (IV) results show that being enrolled in the NCMS reduces the probability of individual-level migrating. The IV is a time-variant dummy indicating the counties that have relative early NCMS implementations. I also use the CHNS to construct a county-level dataset and replicate the county-level results. Together, the results suggest that the NCMS “locks” the rural labour force into rural areas and further hinders geographical job mobility in China.

Suggested Citation

  • Shi, Xuezhu, 2020. "Locked out? China’s health insurance scheme and internal migration," Labour Economics, Elsevier, vol. 67(C).
    • Handle: RePEc:eee:labeco:v:67:y:2020:i:c:s0927537120301354
    DOI: 10.1016/j.labeco.2020.101931
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0927537120301354
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.labeco.2020.101931?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    2. Todaro, Michael P, 1969. "A Model for Labor Migration and Urban Unemployment in Less Developed Countries," American Economic Review, American Economic Association, vol. 59(1), pages 138-148, March.
    3. Robert W. Fairlie & Kanika Kapur & Susan Gates, 2016. "Job Lock: Evidence from a Regression Discontinuity Design," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 55(1), pages 92-121, January.
    4. 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.
    5. 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.
    6. Shi, Li., 2008. "Rural migrant workers in China : scenario, challenges and public policy," ILO Working Papers 994204063402676, International Labour Organization.
    7. Gruber, Jonathan & Madrian, Brigitte C, 1995. "Health-Insurance Availability and the Retirement Decision," American Economic Review, American Economic Association, vol. 85(4), pages 938-948, September.
    8. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    9. Jonathan Gruber & Brigitte C. Madrian, 1993. "Limited Insurance Portability and Job Mobility: The Effects of Public Policy on Job-Lock," NBER Working Papers 4479, National Bureau of Economic Research, Inc.
    10. Junfang Xu & Jian Wang & Madeleine King & Ruiyun Liu & Fenghua Yu & Jinshui Xing & Lei Su & Mingshan Lu, 2018. "Rural–urban disparities in the utilization of mental health inpatient services in China: the role of health insurance," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 377-393, December.
    11. Zhang, Jing, 2012. "The impact of water quality on health: Evidence from the drinking water infrastructure program in rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 122-134.
    12. John Giles & Dewen Wang & Albert Park, 2013. "Expanding Social Insurance Coverage in Urban China," Research in Labor Economics, in: Labor Market Issues in China, pages 123-179, Emerald Group Publishing Limited.
    13. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2011. "Synth: An R Package for Synthetic Control Methods in Comparative Case Studies," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i13).
    14. De Giorgi, Giacomo & Pellizzari, Michele, 2009. "Welfare migration in Europe," Labour Economics, Elsevier, vol. 16(4), pages 353-363, August.
    15. Jonah B. Gelbach, 2004. "Migration, the Life Cycle, and State Benefits: How Low Is the Bottom?," Journal of Political Economy, University of Chicago Press, vol. 112(5), pages 1091-1130, October.
    16. Kaivan Munshi & Mark Rosenzweig, 2016. "Networks and Misallocation: Insurance, Migration, and the Rural-Urban Wage Gap," American Economic Review, American Economic Association, vol. 106(1), pages 46-98, January.
    17. Borjas, George J, 1999. "Immigration and Welfare Magnets," Journal of Labor Economics, University of Chicago Press, vol. 17(4), pages 607-637, October.
    18. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    19. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    20. Harris, John R & Todaro, Michael P, 1970. "Migration, Unemployment & Development: A Two-Sector Analysis," American Economic Review, American Economic Association, vol. 60(1), pages 126-142, March.
    21. Tania Barham & Randall Kuhn, 2014. "Staying for Benefits: The Effect of a Health and Family Planning Program on Out-Migration Patterns in Bangladesh," Journal of Human Resources, University of Wisconsin Press, vol. 49(4), pages 982-1013.
    22. Lex Borghans & Bart H. H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity Aversion," Journal of the European Economic Association, MIT Press, vol. 7(2-3), pages 649-658, 04-05.
    23. Hongmei Yi & Linxiu Zhang & Kim Singer & Scott Rozelle & Scott Atlas, 2009. "Health insurance and catastrophic illness: a report on the New Cooperative Medical System in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 119-127, July.
    24. Wang, Hufeng, 2009. "A dilemma of Chinese healthcare reform: How to re-define government roles?," China Economic Review, Elsevier, vol. 20(4), pages 598-604, December.
    25. Blank, Rebecca M., 1988. "The effect of welfare and wage levels on the location decisions of female-headed households," Journal of Urban Economics, Elsevier, vol. 24(2), pages 186-211, September.
    26. Lucas Goodman, 2017. "The Effect of the Affordable Care Act Medicaid Expansion on Migration," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 211-238, January.
    27. repec:ilo:ilowps:420406 is not listed on IDEAS
    28. Pinka Chatterji & Yue Li, 2016. "Early Effects of the 2010 Affordable Care Act Medicaid Expansions on Federal Disability Program Participation," NBER Working Papers 22531, National Bureau of Economic Research, Inc.
    29. Lex Borghans & Bart H.H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity," Working Papers 200903, Geary Institute, University College Dublin.
    30. Lu, Ming & Xia, Yiran, 2016. "Migration in the People’s Republic of China," ADBI Working Papers 593, Asian Development Bank Institute.
    31. Chen, Shawn Xiaoguang, 2017. "The effect of a fiscal squeeze on tax enforcement: Evidence from a natural experiment in China," Journal of Public Economics, Elsevier, vol. 147(C), pages 62-76.
    32. Terra McKinnish, 2005. "Importing the Poor: Welfare Magnetism and Cross-Border Welfare Migration," Journal of Human Resources, University of Wisconsin Press, vol. 40(1).
    33. McKinnish, Terra, 2007. "Welfare-induced migration at state borders: New evidence from micro-data," Journal of Public Economics, Elsevier, vol. 91(3-4), pages 437-450, April.
    34. Elke U. Weber & Christopher Hsee, 1998. "Cross-Cultural Differences in Risk Perception, but Cross-Cultural Similarities in Attitudes Towards Perceived Risk," Management Science, INFORMS, vol. 44(9), pages 1205-1217, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Friederike Seifert, 2022. "The Affordable Care Act Medicaid expansion and interstate migration in border regions of US States [Die Ausweitung von Medicaid durch den Affordable Care Act und zwischenstaatliche Migration in den," Review of Regional Research: Jahrbuch für Regionalwissenschaft, Springer;Gesellschaft für Regionalforschung (GfR), vol. 42(1), pages 49-74, April.
    2. 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.
    3. Corneo, Giacomo & Neidhöfer, Guido, 2021. "Income redistribution and self-selection of immigrants," Journal of Public Economics, Elsevier, vol. 198(C).
    4. Bairoliya, Neha & Miller, Ray, 2021. "Social insurance, demographics, and rural-urban migration in China," Regional Science and Urban Economics, Elsevier, vol. 91(C).
    5. Corrado Giulietti & Jackline Wahba, 2013. "Welfare migration," Chapters, in: Amelie F. Constant & Klaus F. Zimmermann (ed.), International Handbook on the Economics of Migration, chapter 26, pages 489-504, Edward Elgar Publishing.
    6. De Giorgi, Giacomo & Pellizzari, Michele, 2009. "Welfare migration in Europe," Labour Economics, Elsevier, vol. 16(4), pages 353-363, August.
    7. Assaf Razin & Jackline Wahba, 2015. "Welfare Magnet Hypothesis, Fiscal Burden, and Immigration Skill Selectivity," Scandinavian Journal of Economics, Wiley Blackwell, vol. 117(2), pages 369-402, April.
    8. Katsuyoshi Nakazawa, 2012. "Welfare-Induced Migration of the Elderly in Japan - Gender differences in welfare migration patterns among the elderly," MAGKS Papers on Economics 201242, Philipps-Universität Marburg, Faculty of Business Administration and Economics, Department of Economics (Volkswirtschaftliche Abteilung).
    9. 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.
    10. Assaf Razin, 2013. "MIGRATION into the WELFARE STATE: tax and migration competition," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 20(4), pages 548-563, August.
    11. De Giorgi, Giacomo & Pellizzari, Michele, 2006. "Welfare Migration in Europe and the Cost of a Harmonised Social Assistance," IZA Discussion Papers 2094, Institute of Labor Economics (IZA).
    12. Razin, Assaf & Wahba, Jackline, 2011. "Free vs. Restricted Immigration: Bilateral Country Study," IZA Discussion Papers 5546, Institute of Labor Economics (IZA).
    13. McKinnish, Terra, 2007. "Welfare-induced migration at state borders: New evidence from micro-data," Journal of Public Economics, Elsevier, vol. 91(3-4), pages 437-450, April.
    14. Razin, Assaf & Cohen, Alon, 2008. "The Skill Composition of Immigrants and the Generosity of the Welfare State: Free vs. Policy-Controlled Migration," CEPR Discussion Papers 7034, C.E.P.R. Discussion Papers.
    15. Fiva, Jon H., 2009. "Does welfare policy affect residential choices? An empirical investigation accounting for policy endogeneity," Journal of Public Economics, Elsevier, vol. 93(3-4), pages 529-540, April.
    16. Jin, Zhangfeng & Zhang, Junsen, 2023. "Access to local citizenship and internal migration in a developing country: Evidence from a Hukou reform in China," Journal of Comparative Economics, Elsevier, vol. 51(1), pages 181-215.
    17. Shirley, Peter, 2018. "The response of commuting patterns to cross-border policy differentials: Evidence from the American Community Survey," Regional Science and Urban Economics, Elsevier, vol. 73(C), pages 1-16.
    18. Michał Marcin Kobierecki & Michał Pierzgalski, 2022. "Sports Mega-Events and Economic Growth: A Synthetic Control Approach," Journal of Sports Economics, , vol. 23(5), pages 567-597, June.
    19. Karin Edmark, 2009. "Migration Effects of Welfare Benefit Reform," Scandinavian Journal of Economics, Wiley Blackwell, vol. 111(3), pages 511-526, September.
    20. Caliendo, Marco & Cobb-Clark, Deborah A. & Hennecke, Juliane & Uhlendorff, Arne, 2019. "Locus of control and internal migration," Regional Science and Urban Economics, Elsevier, vol. 79(C).

    More about this item

    Keywords

    Health insurance; Immigrant workers; Public policy;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • 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
    • J68 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Public Policy

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:labeco:v:67:y:2020:i:c:s0927537120301354. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/labeco .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.