Inequality of Opportunity in Health Care in China: Suggestion on the Construction of the Urban-Rural Integrated Medical Insurance System
AbstractThis paper investigates the urban-rural inequality of opportunity in health care in China based on the theory of equality of opportunity of Roemer (1998). Following the compensation principle proposed by Fleurbaey and Schokkaert (2011), this paper establishes a decomposition strategy of the fairness gap, which we use for the measurement of the inequality of opportunity in the urban-rural health care use. Empirical analysis using the CHNS data shows that the ratios of the fairness gap to the directly observed average urban-rural difference in health care are 1.167 during 1997-2000 and 1.744 during 2004-2006, indicating that the average urban-rural difference observed directly from original statistical data may underestimate the degree of the essential inequity. Meanwhile, the increasing fairness gap and the decomposition results imply that generally leveling the urban-rural reimbursement ratios is probably not sufficient, and pro-disadvantage policies should be put in place in order to mitigate or even eliminate the inequality of opportunity in health care use between urban and rural residents. The results are also illuminating for the experiments and establishment of the urban-rural integrated medical insurance system (URIMIS) in China. The pro-disadvantage policies will be more appreciated and effective in the promotion of the equality of opportunity in health care, within the background of urban-rural dualistic social structure and widening urban-rural income gap. This suggestion is supported by data from the URIMIS pilot regions in Jiangsu province. The results show that the fairness gap can be narrowed significantly via pro-disadvantage policies.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by University Library of Munich, Germany in its series MPRA Paper with number 49389.
Date of creation: 01 Sep 2013
Date of revision:
equality of opportunity; health care; fairness gap; urban-rural integrated medical insurance system;
Find related papers by JEL classification:
- D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
- D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-2013-09-06 (All new papers)
- NEP-HEA-2013-09-06 (Health Economics)
- NEP-IAS-2013-09-06 (Insurance Economics)
- NEP-IUE-2013-09-06 (Informal & Underground Economics)
- NEP-TRA-2013-09-06 (Transition Economics)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Zhang, Yingqiang & Eriksson, Tor, 2009.
"Inequality of Opportunity and Income Inequality in Nine Chinese Provinces, 1989-2006,"
09-18, University of Aarhus, Aarhus School of Business, Department of Economics.
- Zhang, Yingqiang & Eriksson, Tor, 2010. "Inequality of opportunity and income inequality in nine Chinese provinces, 1989-2006," China Economic Review, Elsevier, vol. 21(4), pages 607-616, December.
- Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.
- Francois Bourguignon & Francisco H.B. Ferreira & Marta Menéndez, 2005.
"Inequality of Opportunity in Brazil,"
Ibero America Institute for Econ. Research (IAI) Discussion Papers
133, Ibero-America Institute for Economic Research.
- 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.
- Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
- Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
- 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 S25-S46, July.
- Silvia Balia & Andrew M. Jones, 2011.
"Catching the habit: a study of inequality of opportunity in smoking‐related mortality,"
Journal of the Royal Statistical Society Series A,
Royal Statistical Society, vol. 174(1), pages 175-194, January.
- Balia S & Jones A.M, 2009. "Catching the habit: a study of inequality of opportunity in smoking-related mortality," Health, Econometrics and Data Group (HEDG) Working Papers 09/08, HEDG, c/o Department of Economics, University of York.
- Thomas G. McGuire & Margarita Alegria & Benjamin L. Cook & Kenneth B. Wells & Alan M. Zaslavsky, 2006. "Implementing the Institute of Medicine Definition of Disparities: An Application to Mental Health Care," Mathematica Policy Research Reports 5096, Mathematica Policy Research.
- Trannoy, A & Tubeuf, S & Jusot, F & Devaux, M, 2008.
"Inequality in Opportunities in Health in France: A first pass,"
Health, Econometrics and Data Group (HEDG) Working Papers
08/24, HEDG, c/o Department of Economics, University of York.
- Alain Trannoy & Sandy Tubeuf & Florence Jusot & Marion Devaux, 2010. "Inequality of opportunities in health in France: a first pass," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 921-938, August.
- Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence & Devaux, Marion, 2010. "Inequality of Opportunities in Health in France: A First Pass," Economics Papers from University Paris Dauphine 123456789/268, Paris Dauphine University.
- Angus Deaton, 2002.
"Health, inequality, and economic development,"
270, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Angus Deaton, 2001. "Health, Inequality, and Economic Development," NBER Working Papers 8318, National Bureau of Economic Research, Inc.
- Deaton, A., 2001. "Health, Inequality, and Economic Development," Papers 200, Princeton, Woodrow Wilson School - Development Studies.
- Angus Deaton, 2002. "Health, inequality, and economic development," Working Papers 209, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
- Francisco H. G. Ferreira & Jérémie Gignoux, 2011.
"The Measurement Of Inequality Of Opportunity: Theory And An Application To Latin America,"
Review of Income and Wealth,
International Association for Research in Income and Wealth, vol. 57(4), pages 622-657, December.
- Ferreira , Francisco H. G. & Gignoux, Jeremie, 2008. "The measurement of inequality of opportunity : theory and an application to Latin America," Policy Research Working Paper Series 4659, The World Bank.
- Andrew Jones & Nigel Rice & Pedro Rosa Dias, 2012.
"Quality of schooling and inequality of opportunity in health,"
Springer, vol. 42(2), pages 369-394, April.
- Jones, A; & Rice, N; & Rosa Dias, P;, 2010. "Quality of Schooling and Inequality of Opportunity in Health," Health, Econometrics and Data Group (HEDG) Working Papers 10/22, HEDG, c/o Department of Economics, University of York.
- Heckman, James J & Ichimura, Hidehiko & Todd, Petra, 1998. "Matching as an Econometric Evaluation Estimator," Review of Economic Studies, Wiley Blackwell, vol. 65(2), pages 261-94, April.
- Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence, 2010.
"Inequality of Opportunities in Health in Europe : Why So Much Difference Across Countries ?,"
Economics Papers from University Paris Dauphine
123456789/7032, Paris Dauphine University.
- Jusot, F; & Tubeuf, S; & Trannoy, T;, 2010. "Inequality of Opportunities in Health in Europe: Why So Much Difference Across Countries?," Health, Econometrics and Data Group (HEDG) Working Papers 10/26, HEDG, c/o Department of Economics, University of York.
- Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
- Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
- FLEURBAEY, Marc & SCHOKKAERT, Erik, .
"Unfair inequalities in health and health care,"
CORE Discussion Papers RP
-2141, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- David Roodman, 2011. "Fitting fully observed recursive mixed-process models with cmp," Stata Journal, StataCorp LP, vol. 11(2), pages 159-206, June.
- Partha Deb & Pravin K. Trivedi, 2006. "Specification and simulated likelihood estimation of a non-normal treatment-outcome model with selection: Application to health care utilization," Econometrics Journal, Royal Economic Society, vol. 9(2), pages 307-331, 07.
- Pedro Rosa Dias, 2010. "Modelling opportunity in health under partial observability of circumstances," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 252-264.
Blog mentionsAs found by EconAcademics.org, the blog aggregator for Economics research:
- #HEJC papers for October 2013
by academichealtheconomists in The Academic Health Economists' Blog on 2013-09-30 23:30:26
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Ekkehart Schlicht).
If references are entirely missing, you can add them using this form.