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Economic reforms and health insurance in China

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  • Du, Juan

Abstract

During the 1990s, Chinese state-owned enterprises (SOEs) and collective enterprises continually decreased coverage of public health insurance to their employees. This paper investigates this changing pattern of health insurance coverage in China using panel data from the China Nutrition and Health Survey (1991-2000). It is the first attempt in this literature that tries to identify precisely the effects of specific policies and reforms on health insurance coverage in the transitional period of China. The fixed effects linear model clustering at the province level is used for estimation, and results are compared to alternative models, including pooled OLS, random effects GLS model and fixed effects logit model. Strong empirical evidence is found that unemployment as a side effect of the Open Door Policy, and the deregulation of SOE and collective enterprises were the main causes for the decreasing trend. For example, urban areas that were highly affected by the Open Door Policy were associated with 17 percentage points decrease in the insurance coverage. Moreover, I found evidence that the gaps between SOE and non-SOE employees, collective and non-collective employees, urban and rural employees have considerably decreased during the ten years.

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  • Du, Juan, 2009. "Economic reforms and health insurance in China," Social Science & Medicine, Elsevier, vol. 69(3), pages 387-395, August.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:3:p:387-395
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    1. Chen, Aimin, 2005. "Assessing China's economic performance since 1978: Material attainments and beyond," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 34(4), pages 499-527, August.
    2. 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, January.
    3. Hsiao, William C. L., 1995. "The Chinese health care system: Lessons for other nations," Social Science & Medicine, Elsevier, vol. 41(8), pages 1047-1055, October.
    4. Sylvie Démurger & Jeffrey D. Sachs & Wing Thye Woo & Shuming Bao & Gene Chang & Andrew Mellinger, 2002. "Geography, Economic Policy, and Regional Development in China," Asian Economic Papers, MIT Press, vol. 1(1), pages 146-197.
    5. Liu, Yuanli & Hsiao, William C. & Eggleston, Karen, 1999. "Equity in health and health care: the Chinese experience," Social Science & Medicine, Elsevier, vol. 49(10), pages 1349-1356, November.
    6. 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, vol. 58(2), pages 293-304, January.
    7. 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.
    8. Gallup, John L. & Sachs, Jeffrey D. & Mellinger, Andrew, "undated". "Geography and Economic Development," Instructional Stata datasets for econometrics geodata, Boston College Department of Economics.
    9. Li, Wei, 1997. "The Impact of Economic Reform on the Performance of Chinese State Enterprises, 1980-1989," Journal of Political Economy, University of Chicago Press, vol. 105(5), pages 1080-1106, October.
    10. 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, June.
    11. Kaestner, Robert & Kaushal, Neeraj, 2003. "Welfare reform and health insurance coverage of low-income families," Journal of Health Economics, Elsevier, vol. 22(6), pages 959-981, November.
    12. Lin, Justin Yifu, 1992. "Rural Reforms and Agricultural Growth in China," American Economic Review, American Economic Association, vol. 82(1), pages 34-51, March.
    13. HO, Lok Sang, 1995. "Market reforms and China's health care system," Social Science & Medicine, Elsevier, vol. 41(8), pages 1065-1072, October.
    14. Grogan, Colleen M., 1995. "Urban economic reform and access to health care coverage in the People's Republic of China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1073-1084, October.
    15. John Giles & Albert Park & Fang Cai, 2003. "How has Economic Restructuring Affected China???s Urban Workers?," William Davidson Institute Working Papers Series 2003-628, William Davidson Institute at the University of Michigan.
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    Cited by:

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    2. Liu, Jun-Qiang, 2011. "Dynamics of social health insurance development: Examining the determinants of Chinese basic health insurance coverage with panel data," Social Science & Medicine, Elsevier, vol. 73(4), pages 550-558, August.
    3. Yu, Hao, 2015. "Universal health insurance coverage for 1.3 billion people: What accounts for China's success?," Health Policy, Elsevier, vol. 119(9), pages 1145-1152.
    4. Juergen Jung & Jialu Liu Streeter, 2015. "Does health insurance decrease health expenditure risk in developing countries? The case of China," Southern Economic Journal, John Wiley & Sons, vol. 82(2), pages 361-384, October.
    5. Xu Cui & Jing Jian Xiao & Jingtao Yi, 2019. "Employment Type, Residential Status And Consumer Financial Capability: Evidence From China Household Finance Survey," The Singapore Economic Review (SER), World Scientific Publishing Co. Pte. Ltd., vol. 64(01), pages 57-81, March.
    6. Carine Milcent & Feng Jin, 2010. "Decrease in the healthcare demand in rural China: A side effect of the industrialization process?," PSE Working Papers halshs-00564848, HAL.
    7. Linda G. Martin & Qiushi Feng & Robert F. Schoeni & Yi Zeng, 2014. "Trends in Functional and Activity Limitations among Chinese Oldest-Old, 1998 to 2008," Population and Development Review, The Population Council, Inc., vol. 40(3), pages 475-495, September.
    8. Yinzi Jin & Zhiyuan Hou & Donglan Zhang, 2016. "Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-15, August.

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