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The Impact of Health Insurance Policy on the Health of the Senior Floating Population—Evidence from China

Author

Listed:
  • Yingying Meng

    (Centre for Social Security Studies, Wuhan University, Wuhan 430072, China)

  • Junqiang Han

    (School of Public Management, South-Central University for Nationalities, Wuhan 430074, China)

  • Siqi Qin

    (Department of Sociology, The Chinese University of Hong Kong, Shatin 999077, NT, Hong Kong)

Abstract

The impact of health insurance on residents’ health is one of the focal points of academic research. Due to the fact that China’s medical insurance system is composed of a variety of programs and that the pooling districts are at the lower administrative level, enrollment in different medical insurance programs or at different places may have certain influences on the health of residents. This has mostly been neglected by previous studies. This paper uses data from the 2015 China Migrants Dynamic Survey (CMDS), focusing on the senior floating population and taking the difference in government subsidy proportions as an instrumental variable in order to identify the effects of health insurance programs and regional differences on the health of the senior floating population. Three effects were observed: First, participation in the health insurance system significantly improves floating seniors’ self-rated health. Second, the health status of floating seniors affects their choice of health insurance program: Less healthy persons tend to choose high-paying, wide-coverage basic medical insurance available for urban employees. Using an instrumental variable to control for the problem of endogeneity, it is discovered that compared with the basic medical insurance system for urban residents, the system for urban employees significantly enhances the health of the senior floating population. Third, “adverse selection” could be observed in the choice between enrolling in health insurance at the place of settlement or another place. Senior migrants with worse self-rated health tend to choose place of settlement in order to enjoy higher compensation and less complex reimbursement procedures. With an instrumental variable to control for the problem of endogeneity, it was found that compared with joining the medical insurance system at other places, joining at a place of settlement could improve the health of the floating senior population.

Suggested Citation

  • Yingying Meng & Junqiang Han & Siqi Qin, 2018. "The Impact of Health Insurance Policy on the Health of the Senior Floating Population—Evidence from China," IJERPH, MDPI, vol. 15(10), pages 1-17, October.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:10:p:2159-:d:173154
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    References listed on IDEAS

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    1. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    2. John Cawley & Asako S. Moriya & Kosali Simon, 2015. "The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession," Health Economics, John Wiley & Sons, Ltd., vol. 24(2), pages 206-223, February.
    3. 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.
    4. Bhattacharya, Jayanta & Goldman, Dana & Sood, Neeraj, 2003. "The link between public and private insurance and HIV-related mortality," Journal of Health Economics, Elsevier, vol. 22(6), pages 1105-1122, November.
    5. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    6. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    7. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 597-636.
    8. Bai, Chong-En & Wu, Binzhen, 2014. "Health insurance and consumption: Evidence from China’s New Cooperative Medical Scheme," Journal of Comparative Economics, Elsevier, vol. 42(2), pages 450-469.
    9. Goldman D. P. & Bhattacharya J. & McCaffrey D. F. & Duan N. & Leibowitz A. A. & Joyce G. F. & Morton S. C., 2001. "Effect of Insurance on Mortality in an HIV-Positive Population in Care," Journal of the American Statistical Association, American Statistical Association, vol. 96, pages 883-894, September.
    10. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    11. Hanratty, Maria J, 1996. "Canadian National Health Insurance and Infant Health," American Economic Review, American Economic Association, vol. 86(1), pages 276-284, March.
    12. Ke Jiang & Daming You & Zhendong Li & Wei Wei & Mitchell Mainstone, 2018. "Effects of Rural Medical Insurance on Chronically Ill Patients’ Choice of the Same Hospital Again in Rural Northern China," IJERPH, MDPI, vol. 15(4), pages 1-10, April.
    13. Evelien Bergrath & Milena Pavlova & Wim Groot, 2014. "Attracting Health Insurance Buyers through Selective Contracting: Results of a Discrete-Choice Experiment among Users of Hospital Services in the Netherlands," Risks, MDPI, vol. 2(2), pages 1-25, April.
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    Cited by:

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    2. Jin Liu & Yufeng Lu & Qing Xu & Qing Yang, 2019. "Public Health Insurance, Non-Farm Labor Supply, and Farmers’ Income: Evidence from New Rural Cooperative Medical Scheme," IJERPH, MDPI, vol. 16(23), pages 1-15, December.
    3. Pan, Yan & Zhong, Wen-fang & Yin, Rong & Zheng, Meng & Xie, Kun & Cheng, Shu-yuan & Ling, Li & Chen, Wen, 2022. "Does direct settlement of intra-province medical reimbursements improve financial protection among middle-aged and elderly population in China? Evidence based on CHARLS data," Social Science & Medicine, Elsevier, vol. 308(C).
    4. Nianzhai Ma & Weizeng Sun & Zhen Wang, 2022. "Host Identity and Consumption Behavior: Evidence from Rural–Urban Migrants in China," Sustainability, MDPI, vol. 14(19), pages 1-25, September.
    5. Qiang Yao & Chaojie Liu & Ju Sun, 2020. "Inequality in Health Services for Internal Migrants in China: A National Cross-Sectional Study on the Role of Fund Location of Social Health Insurance," IJERPH, MDPI, vol. 17(17), pages 1-22, August.
    6. Lingchen Liu & Renji Sun & Yan Gu & Kung Cheng Ho, 2020. "The Effect of China’s Health Insurance on the Labor Supply of Middle-aged and Elderly Farmers," IJERPH, MDPI, vol. 17(18), pages 1-23, September.

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