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When Health Care Insurance does not make a Difference – The Case of Health Care ‘Made in China’

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  • Hendrik P. van Dalen

    ()
    (Erasmus Universiteit Rotterdam)

Abstract

Does medical insurance affect health care demand and in the end contribute to improvements in the health status? Evidence for China for the year 2004, by means of the China Health and Nutrition Survey (CHNS), shows that health insurance does not affect health care demand in a significant manner. Counterfactuals suggest that full insurance coverage of the Chinese population will not radically change the health care decisions and may even enlarge the perverse effects of today’s health care system: insured persons are more likely to fall back on self-care when they are injured or ill than on the care of a local clinic. This effect is particularly strong in urban areas. In case of a severe injury hospital consultation is preferred to local clinic or self-care by most people, but still a substantial percentage (20 percent) resorts to self-care or ignores the illness. The high level of out-of-pocket expenses paid by both insured and uninsured patients lies at the root of this problem. Insurance does not offer real protection against unpredictable high health care expenditures and can lead people into a position of long-term poverty or serious liquidity problems.

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Bibliographic Info

Paper provided by Tinbergen Institute in its series Tinbergen Institute Discussion Papers with number 06-091/1.

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Date of creation: 11 Oct 2006
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Handle: RePEc:dgr:uvatin:20060091

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Keywords: health insurance; poverty; China; health care; market failure;

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  1. Teh-Wei Hu & Michael Ong & Zi-Hua Lin & Elizabeth Li, 1999. "The effects of economic reform on health insurance and the financial burden for urban workers in China," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 309-321.
  2. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, Elsevier, vol. 27(4), pages 990-1005, July.
  3. Liu, Xingzhu & Mills, Anne, 2002. "Financing reforms of public health services in China: lessons for other nations," Social Science & Medicine, Elsevier, Elsevier, vol. 54(11), pages 1691-1698, June.
  4. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, American Economic Association, vol. 92(1), pages 51-70, March.
  5. Akin, John S. & Dow, William H. & Lance, Peter M., 2004. "Did the distribution of health insurance in China continue to grow less equitable in the nineties? Results from a longitudinal survey," Social Science & Medicine, Elsevier, Elsevier, vol. 58(2), pages 293-304, January.
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