Does school-based private health insurance improve students’ health status? Evidence from China

Private health insurance is an important supplement to social health insurance. However, there is a lack of research on the impact of school-based private health insurance programs on students’ health in developing countries. This study aims to investigate the causal impact of school-based supplementary private health insurance programs on the self-rated health status of Chinese secondary school students, with an average age of 14, using a longitudinal database, the China Education Panel Survey (CEPS). The study exploits the cross-school variation and discrete feature of the response variable by applying a two-level ordered logit model with a random effect at the school level. An ordered logit propensity score matching method, clustering the standard errors by school, is applied for the robustness check. Lagged values of potential endogenous covariates are included in both methods to control the effect of unobserved individual heterogeneities. The results indicate that participating in uniform school-based private health insurance programs does not improve student self-rated health status, whereas individualized health insurance significantly improves student self-rated health status.