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The Effect of the “Triple-Layer Medical Security” Policy on the Vulnerability as Expected Poverty of Rural Households: Evidence from Yunnan Province, China

Author

Listed:
  • Jingjing Zhou

    (School of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
    These authors contributed equally to this work.)

  • Yaoyu Zhang

    (Institute of Population Studies, Nanjing University of Posts and Telecommunications, Nanjing 210042, China
    These authors contributed equally to this work.)

  • Yong Sha

    (School of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Nanjing 210023, China)

  • Jianfang Zhou

    (Institute of Population Studies, Nanjing University of Posts and Telecommunications, Nanjing 210042, China)

  • Hang Ren

    (Institute of Population Studies, Nanjing University of Posts and Telecommunications, Nanjing 210042, China)

  • Xin Shen

    (School of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Nanjing 210023, China)

  • Hui Xu

    (School of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Nanjing 210023, China)

Abstract

China launched the “critical battle against poverty” nationwide in 2012. As its main battlefield, Yunnan province promulgated the “triple medical security” (TMS) policy in 2017. This study, based on the pooled cross-section database of 2015–2020 of registered poor households in Yunnan province, employed the logit model to examine the effect of TMS on the vulnerability as expected poverty (VEP) of these households. It found that increasing the reimbursement rates for overall medical expenses and inpatient expenses and decreasing the proportion of out-of-pocket medical payment to income reduced the VEP; increases in the number of sick people in the family increased its VEP, and although the increase in the reimbursement rate for overall medical expenses or for inpatient expenses partially offset the VEP caused by the increase in the number of chronically ill people in the family, the VEP caused by the increase in the number of critically ill people would increase in the short term with the increase in the reimbursement rate for overall medical expenses or for inpatient expenses. The findings help improve policies concerning the medical security and health of the rural poor population, providing theoretical reference and practical guidance for future research.

Suggested Citation

  • Jingjing Zhou & Yaoyu Zhang & Yong Sha & Jianfang Zhou & Hang Ren & Xin Shen & Hui Xu, 2022. "The Effect of the “Triple-Layer Medical Security” Policy on the Vulnerability as Expected Poverty of Rural Households: Evidence from Yunnan Province, China," IJERPH, MDPI, vol. 19(19), pages 1-22, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12936-:d:937612
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    as
    1. Cesar Calvo & Stefan Dercon, 2005. "Measuring Individual Vulnerability," Economics Series Working Papers 229, University of Oxford, Department of Economics.
    2. Silvia Helena Barcellos & Mireille Jacobson, 2015. "The Effects of Medicare on Medical Expenditure Risk and Financial Strain," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 41-70, November.
    3. Wenmei Liao & Jiawei Wang & Ying Lin & Yao Wang, 2021. "Chronic Illness and Income Diversification in Rural China," IJERPH, MDPI, vol. 18(7), pages 1-15, March.
    4. Raúl Del Pozo-Rubio & Isabel Pardo-García & Francisco Escribano-Sotos, 2020. "Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment," IJERPH, MDPI, vol. 17(1), pages 1-19, January.
    5. Christopher Jepsen & Peter Mueser & Kenneth Troske, 2016. "Labor Market Returns to the GED Using Regression Discontinuity Analysis," Journal of Political Economy, University of Chicago Press, vol. 124(3), pages 621-649.
    6. Deepa Narayan & Robert Chambers & Meera K. Shah & Patti Petesch, 2000. "Voices of the Poor : Crying Out for Change," World Bank Publications - Books, The World Bank Group, number 13848, December.
    7. Sanders Korenman & Dahlia K. Remler, 2016. "Including Health Insurance in Poverty Measurement: The Impact of Massachusetts Health Reform on Poverty," NBER Working Papers 21990, National Bureau of Economic Research, Inc.
    8. Mauricio Gallardo, 2018. "Identifying Vulnerability To Poverty: A Critical Survey," Journal of Economic Surveys, Wiley Blackwell, vol. 32(4), pages 1074-1105, September.
    9. Tomoki Fujii, 2016. "Concepts and measurement of vulnerability to poverty and other issues: a review of literature," Chapters, in: Jacques Silber & Guanghua Wan (ed.), The Asian ‘Poverty Miracle’, chapter 3, pages 53-83, Edward Elgar Publishing.
    10. Lu Li & Junnan Jiang & Li Xiang & Xuefeng Wang & Li Zeng & Zhengdong Zhong, 2019. "Impact of Critical Illness Insurance on the Burden of High-Cost Rural Residents in Central China: An Interrupted Time Series Study," IJERPH, MDPI, vol. 16(19), pages 1-11, September.
    11. Muhammad Masood Azeem & Amin W. Mugera & Steven Schilizzi, 2019. "Do Social Protection Transfers Reduce Poverty and Vulnerability to Poverty in Pakistan? Household Level Evidence from Punjab," Journal of Development Studies, Taylor & Francis Journals, vol. 55(8), pages 1757-1783, August.
    12. Korenman, Sanders D. & Remler, Dahlia K., 2016. "Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty," Journal of Health Economics, Elsevier, vol. 50(C), pages 27-35.
    13. Yuan Li Liu & Kai Zhu & Qi Yao Chen & Jing Li & Jin Cai & Tian He & He Ping Liao, 2021. "Impact of the COVID-19 Pandemic on Farm Households’ Vulnerability to Multidimensional Poverty in Rural China," Sustainability, MDPI, vol. 13(4), pages 1-16, February.
    14. Ward, Patrick S., 2016. "Transient Poverty, Poverty Dynamics, and Vulnerability to Poverty: An Empirical Analysis Using a Balanced Panel from Rural China," World Development, Elsevier, vol. 78(C), pages 541-553.
    15. Susanne Milcher, 2010. "Household vulnerability estimates of Roma in Southeast Europe," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 34(4), pages 773-792.
    16. Syed Abdul Hamid & Jennifer Roberts & Paul Mosley, 2011. "Can Micro Health Insurance Reduce Poverty? Evidence From Bangladesh," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 78(1), pages 57-82, March.
    17. Wei Wang & Chongmei Zhang & Yan Guo & Dingde Xu, 2021. "Impact of Environmental and Health Risks on Rural Households’ Sustainable Livelihoods: Evidence from China," IJERPH, MDPI, vol. 18(20), pages 1-15, October.
    18. Abhijit Banerjee & Rema Hanna & Jordan Kyle & Benjamin A. Olken & Sudarno Sumarto, 2018. "Tangible Information and Citizen Empowerment: Identification Cards and Food Subsidy Programs in Indonesia," Journal of Political Economy, University of Chicago Press, vol. 126(2), pages 451-491.
    19. Yongjian Xu & Anupam Garrib & Zhongliang Zhou & Duolao Wang & Jianmin Gao & Xiaowei Yang & Xiaojing Fan & Gang Chen, 2019. "New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach," IJERPH, MDPI, vol. 16(6), pages 1-13, March.
    20. Günther, Isabel & Harttgen, Kenneth, 2009. "Estimating Households Vulnerability to Idiosyncratic and Covariate Shocks: A Novel Method Applied in Madagascar," World Development, Elsevier, vol. 37(7), pages 1222-1234, July.
    21. Zenghui Huo & Mei Zhang & Junhui Han, 2022. "Heterogeneity of Capability Deprivation and Subjective Sense of Gain: Analysis of Factor Mixture Models Based on 892 Rural Households in Six Provinces," IJERPH, MDPI, vol. 19(7), pages 1-16, April.
    22. Fang Su & Nini Song & Nannan Ma & Altynbek Sultanaliev & Jing Ma & Bing Xue & Shah Fahad, 2021. "An Assessment of Poverty Alleviation Measures and Sustainable Livelihood Capability of Farm Households in Rural China: A Sustainable Livelihood Approach," Agriculture, MDPI, vol. 11(12), pages 1-16, December.
    23. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    24. Gu, Yizhen & Deakin, Elizabeth & Long, Ying, 2017. "The effects of driving restrictions on travel behavior evidence from Beijing," Journal of Urban Economics, Elsevier, vol. 102(C), pages 106-122.
    25. Pritchett, Lant & Suryahadi, Asep & Sumarto, Sudarno, 2000. "Quantifying vulnerability to poverty - a proposed measure, applied to Indonesia," Policy Research Working Paper Series 2437, The World Bank.
    26. Glewwe, Paul & Hall, Gillette, 1998. "Are some groups more vulnerable to macroeconomic shocks than others? Hypothesis tests based on panel data from Peru," Journal of Development Economics, Elsevier, vol. 56(1), pages 181-206, June.
    27. Stefan Dercon & Pramila Krishnan, 2000. "Vulnerability, seasonality and poverty in Ethiopia," Journal of Development Studies, Taylor & Francis Journals, vol. 36(6), pages 25-53.
    28. Ouoba, Youmanli & Sawadogo, Natéwindé, 2022. "Food security, poverty and household resilience to COVID-19 in Burkina Faso: Evidence from urban small traders’ households," World Development Perspectives, Elsevier, vol. 25(C).
    29. Guimin Zhang & Xiangling Wu & Ke Wang, 2022. "Research on the Impact and Mechanism of Internet Use on the Poverty Vulnerability of Farmers in China," Sustainability, MDPI, vol. 14(9), pages 1-16, April.
    30. Di Zhou & Kuangyuan Cai & Shaojun Zhong, 2021. "A Statistical Measurement of Poverty Reduction Effectiveness: Using China as an Example," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 153(1), pages 39-64, January.
    31. Amemiya, Takeshi, 1977. "The Maximum Likelihood and the Nonlinear Three-Stage Least Squares Estimator in the General Nonlinear Simultaneous Equation Model," Econometrica, Econometric Society, vol. 45(4), pages 955-968, May.
    32. Maximilian Tremmel & Ulf-G. Gerdtham & Peter M. Nilsson & Sanjib Saha, 2017. "Economic Burden of Obesity: A Systematic Literature Review," IJERPH, MDPI, vol. 14(4), pages 1-18, April.
    33. Jakob Haan & Regina Pleninger & Jan-Egbert Sturm, 2022. "Does Financial Development Reduce the Poverty Gap?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 161(1), pages 1-27, May.
    34. Linda S. Goldberg & José Manuel Campa, 2010. "The Sensitivity of the CPI to Exchange Rates: Distribution Margins, Imported Inputs, and Trade Exposure," The Review of Economics and Statistics, MIT Press, vol. 92(2), pages 392-407, May.
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