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Public health insurance and the labor market: Evidence from China's Urban Resident Basic Medical Insurance

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  • Wei Si

Abstract

This study provides empirical evidence on the labor market effects of public health insurance using evidence from China. In 2007, China launched a national public health insurance program, Urban Resident Basic Medical Insurance (URBMI), targeting residents in urban areas who were not insured by employment‐based health insurance. Using panel data from the China Health and Nutrition Survey, I identify the impacts of the program based on its staggered implementation across cities. I find that URBMI did not have a significant average causal effect on labor force participation. However, it did increase employment mobility, as evidenced by the decrease in long‐term employment and expansion of fixed‐term contract jobs and self‐employment. After the program was implemented, job lock declined and job flexibility increased, especially among women, the less educated, and individuals with good health status. The results also suggest increased employment for unhealthy workers, indicating a direct health improvement effect.

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  • Wei Si, 2021. "Public health insurance and the labor market: Evidence from China's Urban Resident Basic Medical Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 403-431, February.
    • Handle: RePEc:wly:hlthec:v:30:y:2021:i:2:p:403-431
    DOI: 10.1002/hec.4198
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    as
    1. Meng, Xin & Shen, Kailing & Xue, Sen, 2013. "Economic reform, education expansion, and earnings inequality for urban males in China, 1988–2009," Journal of Comparative Economics, Elsevier, vol. 41(1), pages 227-244.
    2. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2014. "Public Health Insurance, Labor Supply, and Employment Lock," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 129(2), pages 653-696.
    3. Bradley T. Heim & Ithai Z. Lurie, 2015. "The Impact of Health Reform on Job Mobility: Evidence from Massachusetts," American Journal of Health Economics, MIT Press, vol. 1(3), pages 374-398, Summer.
    4. Wagstaff, Adam & Manachotphong, Wanwiphang, 2012. "Universal health care and informal labor markets : the case of Thailand," Policy Research Working Paper Series 6116, The World Bank.
    5. Fairlie, Robert W. & Kapur, Kanika & Gates, Susan, 2011. "Is employer-based health insurance a barrier to entrepreneurship?," Journal of Health Economics, Elsevier, vol. 30(1), pages 146-162, January.
    6. Azuara, Oliver & Marinescu, Ioana, 2013. "Informality and the expansion of social protection programs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 32(5), pages 938-950.
    7. Gruber, Jonathan & Hanratty, Maria, 1995. "The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada," Journal of Business & Economic Statistics, American Statistical Association, vol. 13(2), pages 163-173, April.
    8. Adriana Camacho & Emily Conover & Alejandro Hoyos, 2014. "Effects of Colombia's Social Protection System on Workers' Choice between Formal and Informal Employment," The World Bank Economic Review, World Bank, vol. 28(3), pages 446-466.
    9. Lan Liu & Xiao-yuan Dong & Xiaoying Zheng, 2010. "Parental Care and Married Women's Labor Supply in Urban China," Feminist Economics, Taylor & Francis Journals, vol. 16(3), pages 169-192.
    10. Skriabikova, Olga J. & Dohmen, Thomas & Kriechel, Ben, 2014. "New evidence on the relationship between risk attitudes and self-employment," Labour Economics, Elsevier, vol. 30(C), pages 176-184.
    11. Feng Huang & Li Gan`, 2017. "The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 149-163, February.
    12. repec:wyi:journl:002165 is not listed on IDEAS
    13. Chyi, Hau & Zhou, Bo, 2014. "The effects of tuition reforms on school enrollment in rural China," Economics of Education Review, Elsevier, vol. 38(C), pages 104-123.
    14. Jay Pan & Xiaoyan Lei & Gordon G. Liu, 2016. "Health Insurance and Health Status: Exploring the Causal Effect from a Policy Intervention," Health Economics, John Wiley & Sons, Ltd., vol. 25(11), pages 1389-1402, November.
    15. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    16. Brigitte C. Madrian, 1994. "Employment-Based Health Insurance and Job Mobility: Is there Evidence of Job-Lock?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(1), pages 27-54.
    17. Moffitt, Robert & Wolfe, Barbara L, 1992. "The Effect of the Medicaid Program on Welfare Participation and Labor Supply," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 615-626, November.
    18. Wanchuan Lin & Gordon G. Liu & Gang Chen, 2009. "The Urban Resident Basic Medical Insurance: a landmark reform towards universal coverage in China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 83-96, July.
    19. Li, Hongbin & Meng, Lingsheng & Shi, Xinzheng & Wu, Binzhen, 2012. "Does attending elite colleges pay in China?," Journal of Comparative Economics, Elsevier, vol. 40(1), pages 78-88.
    20. Yang Li & Yinjun Zhao & Danhui Yi & Xiaojun Wang & Yan Jiang & Yu Wang & Xinchun Liu & Shuangge Ma, 2017. "Differences exist across insurance schemes in China post-consolidation," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-13, November.
    21. Aaron S. Yelowitz, 1995. "The Medicaid Notch, Labor Supply, and Welfare Participation: Evidence from Eligibility Expansions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(4), pages 909-939.
    22. Borjas, George J., 2003. "Welfare reform, labor supply, and health insurance in the immigrant population," Journal of Health Economics, Elsevier, vol. 22(6), pages 933-958, November.
    23. Zhuan Pei & Jörn-Steffen Pischke & Hannes Schwandt, 2019. "Poorly Measured Confounders are More Useful on the Left than on the Right," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(2), pages 205-216, April.
    24. Le Wang, 2013. "How Does Education Affect the Earnings Distribution in Urban China?," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 75(3), pages 435-454, June.
    25. Boyle, Melissa A. & Lahey, Joanna N., 2010. "Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion," Journal of Public Economics, Elsevier, vol. 94(7-8), pages 467-478, August.
    26. Liu, Hong & Zhao, Zhong, 2014. "Does health insurance matter? Evidence from China’s urban resident basic medical insurance," Journal of Comparative Economics, Elsevier, vol. 42(4), pages 1007-1020.
    27. Pauline Leung & Alexandre Mas, 2018. "Employment Effects of the Affordable Care Act Medicaid Expansions," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 57(2), pages 206-234, April.
    28. Fenglian Du & Xiao-yuan Dong, 2013. "Women's Employment and Child Care Choices in Urban China during the Economic Transition," Economic Development and Cultural Change, University of Chicago Press, vol. 62(1), pages 131-155.
    29. Laura Dague & Thomas DeLeire & Lindsey Leininger, 2017. "The Effect of Public Insurance Coverage for Childless Adults on Labor Supply," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 124-154, May.
    30. Jeffrey M. Wooldridge, 2002. "Inverse probability weighted M-estimators for sample selection, attrition, and stratification," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 1(2), pages 117-139, August.
    31. Strumpf, Erin, 2011. "Medicaid's effect on single women's labor supply: Evidence from the introduction of Medicaid," Journal of Health Economics, Elsevier, vol. 30(3), pages 531-548, May.
    32. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    33. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    34. Jones-Smith, Jessica C. & Popkin, Barry M., 2010. "Understanding community context and adult health changes in China: Development of an urbanicity scale," Social Science & Medicine, Elsevier, vol. 71(8), pages 1436-1446, October.
    35. Anne E. Winkler, 1991. "The Incentive Effects of Medicaid on Women's Labor Supply," Journal of Human Resources, University of Wisconsin Press, vol. 26(2), pages 308-337.
    36. Björn Gustafsson & Shi Li, 2000. "Economic transformation and the gender earnings gap in urban China," Journal of Population Economics, Springer;European Society for Population Economics, vol. 13(2), pages 305-329.
    37. Hamersma, Sarah & Kim, Matthew, 2009. "The effect of parental Medicaid expansions on job mobility," Journal of Health Economics, Elsevier, vol. 28(4), pages 761-770, July.
    38. Katherine Baicker & Amy Finkelstein & Jae Song & Sarah Taubman, 2014. "The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment," American Economic Review, American Economic Association, vol. 104(5), pages 322-328, May.
    39. Ricardo Bitran, 2014. "Universal Health Coverage and the Challenge of Informal Employment: Lessons from Developing Countries," Health, Nutrition and Population (HNP) Discussion Paper Series 87077, The World Bank.
    40. Liu, Lulu & Zhang, Yuting, 2018. "Does non-employment based health insurance promote entrepreneurship? Evidence from a policy experiment in China," Journal of Comparative Economics, Elsevier, vol. 46(1), pages 270-283.
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    1. Chris Sampson’s journal round-up for 8th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-08 12:00:01

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