IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v22y2022i4d10.1007_s10754-022-09326-9.html
   My bibliography  Save this article

Does supplemental private health insurance incentivize household risky financial asset investment? Evidence from the China Household Financial Survey

Author

Listed:
  • Si Shi

    (Sun Yat-Sen University)

  • Yawen Jiang

    (Sun Yat-Sen University)

Abstract

Private health insurance (PHI) is considered a supplement to public medical insurance schemes in China. To the extent that PHI coverage may offset background risk by decreasing medical expenditure risk, it may also incentivize risky financial behaviors. However, empirical evidence confirming this theory is absent in China. We fill this void by examining the impact of supplemental PHI on household risky financial investment using data from the China Household Financial Survey (CHFS). In the first set of analyses, we used bivariate probit (BVP) models with instrumental variables (IVs) to examine the effects of PHI on the extensive margin of household risky financial investment. In the second set of analyses, we used Tobit models with a two-stage residual inclusion (2SRI) framework to examine the effects of PHI on the corresponding intensive margin. The results indicated that supplemental PHI increased the probability of holding risky financial assets. On top of that, PHI increased the percentage of total financial assets allocated to risky financial investment. Such effects were more pronounced on stocks than on other risky products. Our findings provided evidence that purchasing supplemental PHI in China may increase the risk tolerance of financial investment, and risk attitude is a mediating factor between PHI ownership and risky financial investment behavior.

Suggested Citation

  • 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.
  • Handle: RePEc:kap:ijhcfe:v:22:y:2022:i:4:d:10.1007_s10754-022-09326-9
    DOI: 10.1007/s10754-022-09326-9
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10754-022-09326-9
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s10754-022-09326-9?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. Angrisani, Marco & Atella, Vincenzo & Brunetti, Marianna, 2018. "Public health insurance and household portfolio Choices: Unravelling financial “Side Effects” of Medicare," Journal of Banking & Finance, Elsevier, vol. 93(C), pages 198-212.
    2. Atella, Vincenzo & Brunetti, Marianna & Maestas, Nicole, 2012. "Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE," Journal of Banking & Finance, Elsevier, vol. 36(5), pages 1320-1335.
    3. Dana Goldman & Nicole Maestas, 2013. "Medical Expenditure Risk And Household Portfolio Choice," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(4), pages 527-550, June.
    4. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2003. "Instrumental variables and GMM: Estimation and testing," Stata Journal, StataCorp LP, vol. 3(1), pages 1-31, March.
    5. David A. Love & Paul A. Smith, 2010. "Does health affect portfolio choice?," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1441-1460, December.
    6. 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.
    7. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    8. Hans-Martin Von Gaudecker, 2015. "How Does Household Portfolio Diversification Vary with Financial Literacy and Financial Advice?," Journal of Finance, American Finance Association, vol. 70(2), pages 489-507, April.
    9. Marcos D. Chamon & Eswar S. Prasad, 2010. "Why Are Saving Rates of Urban Households in China Rising?," American Economic Journal: Macroeconomics, American Economic Association, vol. 2(1), pages 93-130, January.
    10. Levy, Haim & Levy, Moshe, 2002. "Arrow-Pratt Risk Aversion, Risk Premium and Decision Weights," Journal of Risk and Uncertainty, Springer, vol. 25(3), pages 265-290, November.
    11. Sandra E Black & Paul J Devereux & Petter Lundborg & Kaveh Majlesi, 2018. "Learning to Take Risks? The Effect of Education on Risk-Taking in Financial Markets," Review of Finance, European Finance Association, vol. 22(3), pages 951-975.
    12. Cardak, Buly A. & Wilkins, Roger, 2009. "The determinants of household risky asset holdings: Australian evidence on background risk and other factors," Journal of Banking & Finance, Elsevier, vol. 33(5), pages 850-860, May.
    13. Chamberlain, Gary, 1983. "A characterization of the distributions that imply mean--Variance utility functions," Journal of Economic Theory, Elsevier, vol. 29(1), pages 185-201, February.
    14. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).
    15. Pratt, John W & Zeckhauser, Richard J, 1987. "Proper Risk Aversion," Econometrica, Econometric Society, vol. 55(1), pages 143-154, January.
    16. Kimball, Miles S, 1993. "Standard Risk Aversion," Econometrica, Econometric Society, vol. 61(3), pages 589-611, May.
    17. Meiling Ying & Zaichao Du, 2012. "The effects of medical insurance on durables consumption in rural China," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 4(2), pages 176-187, May.
    18. Stock, James H & Wright, Jonathan H & Yogo, Motohiro, 2002. "A Survey of Weak Instruments and Weak Identification in Generalized Method of Moments," Journal of Business & Economic Statistics, American Statistical Association, vol. 20(4), pages 518-529, October.
    19. Rosen, H.S.Harvey S. & Wu, Stephen, 2004. "Portfolio choice and health status," Journal of Financial Economics, Elsevier, vol. 72(3), pages 457-484, June.
    20. He, Zekai & Shi, Xiuzhen & Lu, Xiaomeng & Li, Feng, 2019. "Home equity and household portfolio choice: Evidence from China," International Review of Economics & Finance, Elsevier, vol. 60(C), pages 149-164.
    21. Yawen Jiang & Weiyi Ni, 2019. "Risk selection into supplemental private health insurance in China," Health Economics Review, Springer, vol. 9(1), pages 1-11, December.
    22. Courtney Coile & Kevin Milligan, 2009. "How Household Portfolios Evolve After Retirement: The Effect Of Aging And Health Shocks," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 55(2), pages 226-248, June.
    23. Louis Eeckhoudt & Christian Gollier & Harris Schlesinger, 1995. "The Risk-Averse (and Prudent) Newsboy," Management Science, INFORMS, vol. 41(5), pages 786-794, May.
    24. Li Gan & Zhichao Yin & Nan Jia & Shu Xu & Shuang Ma & Lu Zheng, 2014. "Data you need to know about China," Springer Books, Springer, edition 127, number 978-3-642-38151-5, September.
    25. Blomqvist, Åke, 2009. "Health system reform in China: What role for private insurance?," China Economic Review, Elsevier, vol. 20(4), pages 605-612, December.
    26. Naomi Zewde, 2021. "Did Marketplace coverage really offer financial protection? Financial gains from the Affordable Care Act's private insurance policies among the previously uninsured," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(2), pages 413-427, June.
    27. Anirban Basu & Norma B. Coe & Cole G. Chapman, 2018. "2SLS versus 2SRI: Appropriate methods for rare outcomes and/or rare exposures," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 937-955, June.
    28. Tan, Si Ying & Wu, Xun & Yang, Wei, 2019. "Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China," Health Economics, Policy and Law, Cambridge University Press, vol. 14(4), pages 468-486, October.
    29. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/generalized method of moments estimation and testing," Stata Journal, StataCorp LP, vol. 7(4), pages 465-506, December.
    30. Gollier, Christian & Pratt, John W, 1996. "Risk Vulnerability and the Tempering Effect of Background Risk," Econometrica, Econometric Society, vol. 64(5), pages 1109-1123, September.
    31. 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.
    32. Shum, Pauline & Faig, Miquel, 2006. "What explains household stock holdings?," Journal of Banking & Finance, Elsevier, vol. 30(9), pages 2579-2597, September.
    33. Edwards, Ryan D, 2008. "Health Risk and Portfolio Choice," Journal of Business & Economic Statistics, American Statistical Association, vol. 26, pages 472-485.
    34. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    35. Kathleen Arano & Carl Parker & Rory Terry, 2010. "Gender‐Based Risk Aversion And Retirement Asset Allocation," Economic Inquiry, Western Economic Association International, vol. 48(1), pages 147-155, January.
    36. 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.
    37. Dunfu Zhang & K. M. Atikur Rahman, 2020. "Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1111-1126, September.
    38. Yinan Yang & Qian Wang, 2018. "Insurance Inclusion, Time Preference And Stock Investment Of The Chinese Households," The Singapore Economic Review (SER), World Scientific Publishing Co. Pte. Ltd., vol. 63(01), pages 27-44, March.
    39. Hanming Fang & Michael P. Keane & Dan Silverman, 2008. "Sources of Advantageous Selection: Evidence from the Medigap Insurance Market," Journal of Political Economy, University of Chicago Press, vol. 116(2), pages 303-350, April.
    40. Terence C. Cheng & Jing Li & Rhema Vaithianathan, 2019. "Monthly spending dynamics of the elderly following a health shock: Evidence from Singapore," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 23-43, January.
    41. Zhang, Annie C. & Fang, Jiali & Jacobsen, Ben & Marshall, Ben R., 2018. "Peer effects, personal characteristics and asset allocation," Journal of Banking & Finance, Elsevier, vol. 90(C), pages 76-95.
    42. Zou, Jing & Deng, Xiaojun, 2019. "Financial literacy, housing value and household financial market participation: Evidence from urban China," China Economic Review, Elsevier, vol. 55(C), pages 52-66.
    43. Bonaparte, Yosef & Korniotis, George M. & Kumar, Alok, 2014. "Income hedging and portfolio decisions," Journal of Financial Economics, Elsevier, vol. 113(2), pages 300-324.
    44. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    45. Jing Zhou & Tianhua Xiao, 2018. "Analyzing Determinants of Household Financial Decision-Making: Household Stock Investment in China," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 54(15), pages 3385-3400, December.
    Full references (including those not matched with items on IDEAS)

    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. Angrisani, Marco & Atella, Vincenzo & Brunetti, Marianna, 2018. "Public health insurance and household portfolio Choices: Unravelling financial “Side Effects” of Medicare," Journal of Banking & Finance, Elsevier, vol. 93(C), pages 198-212.
    2. Dana Goldman & Nicole Maestas, 2013. "Medical Expenditure Risk And Household Portfolio Choice," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(4), pages 527-550, June.
    3. Zhongda Li & Lu Liu & Jiayu Shi & Yubing Sui, 2021. "Health insurance, risk attitudes, and household financial behavior," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1239-1246, May.
    4. Christophe Courbage & Guillem Montoliu-Montes & Béatrice Rey, 2018. "How vulnerable is risk aversion to wealth, health and other risks? An empirical analysis for Europe," Working Papers halshs-01935846, HAL.
    5. Lee, Daeyong, 2018. "Effects of health insurance coverage on household financial portfolio: Evidence from the Affordable Care Act," Economics Letters, Elsevier, vol. 171(C), pages 176-179.
    6. Inmaculada Aguiar-Díaz & María Victoria Ruiz-Mallorqui, 2022. "Private Health Insurance and Financial Risk Taking in Spain—The Moderating Effect of Subjective Risk Tolerance," IJERPH, MDPI, vol. 19(23), pages 1-13, December.
    7. Christophe Courbage & Guillem Montoliu-Montes & Béatrice Rey, 2018. "How vulnerable is risk aversion to wealth, health and other risks? An empirical analysis for Europe," Working Papers 1827, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    8. Atella, Vincenzo & Brunetti, Marianna & Maestas, Nicole, 2012. "Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE," Journal of Banking & Finance, Elsevier, vol. 36(5), pages 1320-1335.
    9. Strobl, Renate, 2022. "Background risk, insurance and investment behaviour: Experimental evidence from Kenya," Journal of Economic Behavior & Organization, Elsevier, vol. 202(C), pages 34-68.
    10. Kronenberg, C. & van Kippersluis, H. & Rohde, K.I.M., 2014. "What drives the association between health and portfolio choice?," Health, Econometrics and Data Group (HEDG) Working Papers 14/27, HEDG, c/o Department of Economics, University of York.
    11. Xinxin Ma, 2022. "Medical Insurances and Financial Portfolio Choice," Springer Books, in: Public Medical Insurance Reforms in China, chapter 0, pages 193-215, Springer.
    12. Xinxin Ma, 2022. "Social Insurances and Risky Financial Market Participation: Evidence from China," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 58(10), pages 2957-2975, August.
    13. Jiang, Chonghui & Ma, Yongkai & An, Yunbi, 2010. "An analysis of portfolio selection with background risk," Journal of Banking & Finance, Elsevier, vol. 34(12), pages 3055-3060, December.
    14. Padmaja Ayyagari & Daifeng He, 2017. "The Role of Medical Expenditure Risk in Portfolio Allocation Decisions," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1447-1458, November.
    15. Saruultuya Tsendsuren & Chu-Shiu Li & Sheng-Chang Peng & Wing-Keung Wong, 2018. "The Effects of Health Status on Life Insurance Holdings in 16 European Countries," Sustainability, MDPI, vol. 10(10), pages 1-30, September.
    16. Christelis, Dimitris & Georgarakos, Dimitris & Sanz-de-Galdeano, Anna, 2020. "The impact of health insurance on stockholding: A regression discontinuity approach," Journal of Health Economics, Elsevier, vol. 69(C).
    17. Francisco Gomes & Michael Haliassos & Tarun Ramadorai, 2021. "Household Finance," Journal of Economic Literature, American Economic Association, vol. 59(3), pages 919-1000, September.
    18. Døskeland, Trond & Kværner, Jens, 2022. "Cancer and portfolio choice: Evidence from Norwegian register data," Other publications TiSEM 9efe1b52-789e-496a-84de-4, Tilburg University, School of Economics and Management.
    19. Jiapeng Liu & Rui Lu & Ronghua Yi & Ting Zhang, 2017. "Modelling optimal asset allocation when households experience health shocks," Review of Quantitative Finance and Accounting, Springer, vol. 49(1), pages 245-261, July.
    20. Trond Døskeland & Jens Soerlie Kvaerner, 2022. "Cancer and Portfolio Choice: Evidence from Norwegian Register Data [The age of reason: financial decisions over the life cycle and implications for regulation]," Review of Finance, European Finance Association, vol. 26(2), pages 407-442.

    More about this item

    Keywords

    Private health insurance; Stock; Risky financial investment; Background risk; China;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • G11 - Financial Economics - - General Financial Markets - - - Portfolio Choice; Investment Decisions

    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:kap:ijhcfe:v:22:y:2022:i:4:d:10.1007_s10754-022-09326-9. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.