The expansion of public health insurance and the demand for private health insurance in rural China
This paper examines the impact of the New Cooperative Medical Scheme (NCMS) on private health insurance purchasing decisions in rural China, using longitudinal data from the China Health and Nutrition Survey (CHNS, 2000-2006). A Difference-in-difference (DID) approach is employed to estimate NCMS effects. The overall effects of NCMS were modest, but differed for adults and children. We find that adults were 2.1% more likely to purchase private health insurance when NCMS became available. NCMS had a larger positive effect on adult private coverage in higher income groups and in communities with a preexisting health care financing system, known as the Cooperative Medical Scheme (CMS). We also find evidence suggesting that NCMS crowded out child private health insurance, especially in lower income groups. However, this finding is not robust to controlling for other covariates including household characteristics and availability of private insurance in the community. For both adults and children, risk preferences and socio-economic status, including income and education, are important predictors of private insurance take-up. We find no evidence for adverse selection in the demand for private health insurance.
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- Yuyu Chen & Hongbin Li, 2006.
"Mother's Education and Child Health: Is There a Nurturing Effect?,"
00021, Chinese University of Hong Kong, Department of Economics.
- Chen, Yuyu & Li, Hongbin, 2009. "Mother's education and child health: Is there a nurturing effect?," Journal of Health Economics, Elsevier, vol. 28(2), pages 413-426, March.
- Dennis G. Shea & R. Patrick Stewart, 1995. "Demand for insurance by elderly persons: Private purchases and employer provision," Health Economics, John Wiley & Sons, Ltd., vol. 4(4), pages 315-326, 07.
- Chou, Shin-Yi & Liu, Jin-Tan & Hammitt, James K., 2003. "National Health Insurance and precautionary saving: evidence from Taiwan," Journal of Public Economics, Elsevier, vol. 87(9-10), pages 1873-1894, September.
- 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.
- Strauss, J. & Thomas, D., 1995.
"Health, Nutrition and Economic development,"
95-23, RAND - Labor and Population Program.
- Xueshan, Feng & Shenglan, Tang & Bloom, Gerald & Segall, Malcolm & Xingyuan, Gu, 1995. "Cooperative medical schemes in contemporary rural China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1111-1118, October.
- Ravallion, Martin & Shaohua Chen, 2004.
"China's (uneven) progress against poverty,"
Policy Research Working Paper Series
3408, The World Bank.
- Wang, Hufeng, 2009. "A dilemma of Chinese healthcare reform: How to re-define government roles?," China Economic Review, Elsevier, vol. 20(4), pages 598-604, December.
- Carrin, Guy & Ron, Aviva & Hui, Yang & Hong, Wang & Tuohong, Zhang & Licheng, Zhang & Shuo, Zhang & Yide, Ye & Jiaying, Chen & Qicheng, Jiang & Zhaoyang, Zhang & Jun, Yu & Xuesheng, Li, 1999. "The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties," Social Science & Medicine, Elsevier, vol. 48(7), pages 961-972, April.
- Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334.
- Wang, H. Holly & Rosenman, Robert, 2007. "Perceived need and actual demand for health insurance among rural Chinese residents," China Economic Review, Elsevier, vol. 18(4), pages 373-388.
- 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.
- Cutler, David M & Gruber, Jonathan, 1996.
"Does Public Insurance Crowd Out Private Insurance?,"
The Quarterly Journal of Economics,
MIT Press, vol. 111(2), pages 391-430, May.
- David M. Cutler & Jonathan Gruber, 1995. "Does Public Insurance Crowd Out Private Insurance?," NBER Working Papers 5082, National Bureau of Economic Research, Inc.
- Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
- Wagstaff, Adam & Yu, Shengchao, 2005.
"Do health sector reforms have their intended impacts ? The World Bank's Health VIII project in Gansu province, China,"
Policy Research Working Paper Series
3743, The World Bank.
- Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May.
- Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages S7-S23, July.
- Shore-Sheppard, Lara & Buchmueller, Thomas C. & Jensen, Gail A., 2000. "Medicaid and crowding out of private insurance: a re-examination using firm level data," Journal of Health Economics, Elsevier, vol. 19(1), pages 61-91, January.
- Xiao-Hua Ying & Teh-Wei Hu & Jane Ren & Wen Chen & Ke Xu & Jin-Hui Huang, 2007. "Demand for private health insurance in Chinese urban areas," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1041-1050.
- Gordon G. Liu & Xiaodong Wu & Chaoyang Peng & Alex Z. Fu, 2003. "Urbanization And Health Care In Rural China," Contemporary Economic Policy, Western Economic Association International, vol. 21(1), pages 11-24, 01.
- Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008.
"Health service delivery in China: a literature review,"
John Wiley & Sons, Ltd., vol. 17(2), pages 149-165.
- Eggleston, Karen & Ling, Li & Qingyue, Meng & Lindelow, Magnus & Wagstaff, Adam, 2006. "Health Service Delivery in China: A Literature Review," Policy Research Working Paper Series 3978, The World Bank.
- Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
- Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
- Finkelstein, Amy, 2004.
"The interaction of partial public insurance programs and residual private insurance markets: evidence from the US Medicare program,"
Journal of Health Economics,
Elsevier, vol. 23(1), pages 1-24, January.
- Amy Finkelstein, 2002. "The Interaction of Partial Public Insurance Programs and Residual Private Insurance Markets: Evidence from the U.S. Medicare Program," NBER Working Papers 9031, National Bureau of Economic Research, Inc.
- You, Xuedan & Kobayashi, Yasuki, 2009. "The new cooperative medical scheme in China," Health Policy, Elsevier, vol. 91(1), pages 1-9, June.
- Liu, Tsai-Ching & Chen, Chin-Shyan, 2002. "An analysis of private health insurance purchasing decisions with national health insurance in Taiwan," Social Science & Medicine, Elsevier, vol. 55(5), pages 755-774, September.
- Blomqvist, Åke, 2009. "Health system reform in China: What role for private insurance?," China Economic Review, Elsevier, vol. 20(4), pages 605-612, December.
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