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Impact of urban–rural medical insurance integration on consumption: Evidence from rural China

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  • Chen, Hua
  • Ding, Yugang
  • Tang, Lin
  • Wang, Lizhen

Abstract

Examining the impact of basic medical insurance integration on households’ welfare is essential for finding policy solutions to health and welfare inequality. Based on the different timing of implementing the urban–rural medical insurance integration in different prefectural cities in China, we employ a staggered difference-in-differences model to study the impact of this policy on rural household consumption. We find that the integration policy increases the treatment group’s non-medical consumption by 14% on average, compared to the control group. The effect is more significant for non-food consumption as the price elasticity of non-food demand is larger than that of food demand. As for the mechanism, we find evidence of the direct channel of reduced medical burden, and we also provide some indirect indication of the precautionary savings channel that the effect of medical insurance on household consumption is more significant for households with lower wealth or higher health risks. The policy implication of our findings is considerable since they provide a strong justification for that social insurance integration might be a solution to narrow the health and welfare gap within China.

Suggested Citation

  • Chen, Hua & Ding, Yugang & Tang, Lin & Wang, Lizhen, 2022. "Impact of urban–rural medical insurance integration on consumption: Evidence from rural China," Economic Analysis and Policy, Elsevier, vol. 76(C), pages 837-851.
    • Handle: RePEc:eee:ecanpo:v:76:y:2022:i:c:p:837-851
    DOI: 10.1016/j.eap.2022.09.018
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    1. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    2. Ku, Yu-Chun & Chou, Yiing-Jenq & Lee, Miaw-Chwen & Pu, Christy, 2019. "Effects of National Health Insurance on household out-of-pocket expenditure structure," Social Science & Medicine, Elsevier, vol. 222(C), pages 1-10.
    3. Bai, Chong-En & Wu, Binzhen, 2014. "Health insurance and consumption: Evidence from China’s New Cooperative Medical Scheme," Journal of Comparative Economics, Elsevier, vol. 42(2), pages 450-469.
    4. Zhao, Weimin, 2019. "Does health insurance promote people's consumption? New evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 65-86.
    5. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    6. Andreyeva, T. & Long, M.W. & Brownell, K.D., 2010. "The impact of food prices on consumption: A systematic review of research on the price elasticity of demand for food," American Journal of Public Health, American Public Health Association, vol. 100(2), pages 216-222.
    7. 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.
    8. Doruk Cengiz & Arindrajit Dube & Attila Lindner & Ben Zipperer, 2019. "The Effect of Minimum Wages on Low-Wage Jobs," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1405-1454.
    9. Huang, Xian & Wu, Bingxiao, 2020. "Impact of urban-rural health insurance integration on health care: Evidence from rural China," China Economic Review, Elsevier, vol. 64(C).
    10. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    11. Jing Zhou & Tianhua Xiao, 2018. "Analyzing Determinants of Household Financial Decision-Making: Household Stock Investment in China," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 54(15), pages 3385-3400, December.
    12. Liu, Kai, 2016. "Insuring against health shocks: Health insurance and household choices," Journal of Health Economics, Elsevier, vol. 46(C), pages 16-32.
    13. Patryk Babiarz & Tansel Yilmazer, 2017. "The impact of adverse health events on consumption: Understanding the mediating effect of income transfers, wealth, and health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1743-1758, December.
    14. Andrew Goodman-Bacon, 2018. "Public Insurance and Mortality: Evidence from Medicaid Implementation," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 216-262.
    15. Nitin Mehta & Jian Ni & Kannan Srinivasan & Baohong Sun, 2017. "A Dynamic Model of Health Insurance Choices and Healthcare Consumption Decisions," Marketing Science, INFORMS, vol. 36(3), pages 338-360, May.
    16. Sheu, Ji-Tian & Lu, Jui-fen Rachel, 2014. "The spillover effect of National Health Insurance on household consumption patterns: Evidence from a natural experiment in Taiwan," Social Science & Medicine, Elsevier, vol. 111(C), pages 41-49.
    17. Vo, Thang T. & Van, Pham Hoang, 2019. "Can health insurance reduce household vulnerability? Evidence from Viet Nam," World Development, Elsevier, vol. 124(C), pages 1-1.
    18. Baker, Andrew C. & Larcker, David F. & Wang, Charles C.Y., 2022. "How much should we trust staggered difference-in-differences estimates?," Journal of Financial Economics, Elsevier, vol. 144(2), pages 370-395.
    19. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    20. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
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