Sleeping money: investigating the huge surpluses of social health insurance in China
The spreading of social health insurance (SHI) worldwide poses challenges for fledging public administrators. Inefficiency, misuse and even corruption threaten the stewardship of those newly established health funds. This article examines a tricky situation faced by China’s largest SHI program: the basic health insurance (BHI) scheme for urban employees. BHI accumulated a 406 billion yuan surplus by 2009, although the reimbursement level was still low. Using a provincial level panel database, we find that the huge BHI surpluses are related to the (temporarily) decreasing dependency ratio, the steady growth of average wages, the extension of BHI coverage, and progress in social insurance agency building. The financial situations of local governments and risk pooling level also matter. Besides, medical savings accounts result in about one third of BHI surpluses. Although these findings are not causal, lessons drawn from this study can help to improve the governance and performance of SHI programs in developing countries. Copyright Springer Science+Business Media New York 2013
Volume (Year): 13 (2013)
Issue (Month): 3 (December)
|Contact details of provider:|| Web page: http://www.springerlink.com/link.asp?id=106603|
References listed on IDEAS
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.:
- Win Lin Chou & Zijun Wang, 2009. "Regional inequality in China's health care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages S137-S146, July.
- Liu, Yuanli & Rao, Keqin & Fei, John, 1998. "Economic transition and health transition: comparing China and Russia," Health Policy, Elsevier, vol. 44(2), pages 103-122, May.
- Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
- Ramesh, M. & Wu, Xun, 2009. "Health policy reform in China: Lessons from Asia," Social Science & Medicine, Elsevier, vol. 68(12), pages 2256-2262, June.
- Marwa Farag & A. Nandakumar & Stanley Wallack & Dominic Hodgkin & Gary Gaumer & Can Erbil, 2013. "Health expenditures, health outcomes and the role of good governance," International Journal of Health Care Finance and Economics, Springer, vol. 13(1), pages 33-52, March.
- Liu, Gordon G. & Zhao, Zhongyun & Cai, Renhua & Yamada, Tetsuji & Yamada, Tadashi, 2002. "Equity in health care access to: assessing the urban health insurance reform in China," Social Science & Medicine, Elsevier, vol. 55(10), pages 1779-1794, November.
- Liu, Yuanli, 2002. "Reforming China's urban health insurance system," Health Policy, Elsevier, vol. 60(2), pages 133-150, May.
When requesting a correction, please mention this item's handle: RePEc:kap:ijhcfe:v:13:y:2013:i:3:p:319-331. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla)or (Christopher F. Baum)
If references are entirely missing, you can add them using this form.