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The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?

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  • Xiaoyan Lei
  • Wanchuan Lin

Abstract

This paper explores the impact of the New Cooperative Medical Scheme (NCMS), a newly adopted public health insurance program in rural China. Using a longitudinal sample drawn from the China Health and Nutrition Survey (CHNS), we employed multiple estimation strategies (individual fixed‐effect models, instrumental variable estimation, and difference‐in‐differences estimation with propensity score matching) to correct the potential selection bias. We find that participating in the NCMS significantly decreases the use of traditional Chinese folk doctors and increases the utilization of preventive care, particularly general physical examinations. However, we do not find that the NCMS decreases out‐of‐pocket expenditure nor do we find that it increases utilization of formal medical service or improves health status, as measured by self‐reported health status and by sickness or injury in the past four weeks. Our study indicates that despite the wide expansion of coverage, the impact of the NCMS is still limited. Copyright © 2009 John Wiley & Sons, Ltd.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s25-s46
    DOI: 10.1002/hec.1501
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    References listed on IDEAS

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    1. 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.
    2. Currie, Janet & Gruber, Jonathan & Fischer, Michael, 1995. "Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy," American Economic Review, American Economic Association, vol. 85(2), pages 106-111, May.
    3. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 65-82, July.
    4. Sidel, V.W., 1993. "New lessons from China: Equity and economics in rural health care," American Journal of Public Health, American Public Health Association, vol. 83(12), pages 1665-1666.
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