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Effects Of Ncms On Access To Care And Financial Protection In China

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  • Zhiyuan Hou
  • Ellen Van de Poel
  • Eddy Van Doorslaer
  • Baorong Yu
  • Qingyue Meng

Abstract

The introduction of the New Cooperative Medical Scheme (NCMS) in rural China has been the most rapid and dramatic extension of health insurance coverage in the developing world in this millennium. The literature to date has mainly used the uneven rollout of NCMS across counties as a way of identifying its effects on access to care and financial protection. This study exploits the cross‐county variation in NCMS generosity in 2006 and 2008 in the Ningxia and Shandong provinces to estimate the effect of coverage generosity on utilization and financial protection. Our results confirm earlier findings of NCMS being effective in increasing access to care but not in increasing financial protection. In addition, we find NCMS enrollees to be sensitive to the price incentives set in the NCMS design when choosing their provider and providers to respond by increasing prices and/or providing more expensive care. Copyright © 2013 John Wiley & Sons, Ltd.

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  • Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yu & Qingyue Meng, 2014. "Effects Of Ncms On Access To Care And Financial Protection In China," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 917-934, August.
    • Handle: RePEc:wly:hlthec:v:23:y:2014:i:8:p:917-934
    DOI: 10.1002/hec.2965
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    1. Zhang, Anwen & Nikoloski, Zlatko & Mossialos, Elias, 2017. "Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly," Social Science & Medicine, Elsevier, vol. 190(C), pages 11-19.
    2. Jessica Ya Sun, 2020. "Welfare consequences of access to health insurance for rural households: Evidence from the New Cooperative Medical Scheme in China," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 337-352, March.
    3. Bairoliya, Neha & Miller, Ray, 2021. "Social insurance, demographics, and rural-urban migration in China," Regional Science and Urban Economics, Elsevier, vol. 91(C).
    4. Sun, Xiaojie & Liu, Xiaoyun & Sun, Qiang & Yip, Winnie & Wagstaff, Adam & Meng, Qingyue, 2014. "The impact of a pay-for-performance scheme on prescription quality in rural China : an impact evaluation," Policy Research Working Paper Series 6892, The World Bank.
    5. Jinjing Wu & Shelby Deaton & Boshen Jiao & Zohn Rosen & Peter A Muennig, 2018. "The cost-effectiveness analysis of the New Rural Cooperative Medical Scheme in China," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-13, December.
    6. Diana Cheung & Jean-Pierre Laffargue & Ysaline Padieu, 2016. "Insurance of Household Risks and the Rebalancing of the Chinese Economy: Health Insurance, Health Expenses and Household Savings," Pacific Economic Review, Wiley Blackwell, vol. 21(3), pages 381-412, August.
    7. Bredenkamp, Caryn & Evans, Timothy & Lagrada, Leizel & Langenbrunner, John & Nachuk, Stefan & Palu, Toomas, 2015. "Emerging challenges in implementing universal health coverage in Asia," Social Science & Medicine, Elsevier, vol. 145(C), pages 243-248.
    8. Colin Green & Bruce Hollingsworth & Miaoqing Yang, 2021. "The impact of social health insurance on rural populations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 473-483, April.
    9. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    10. Bairoliya, Neha & Canning, David & Miller, Ray & Saxena, Akshar, 2018. "The macroeconomic and welfare implications of rural health insurance and pension reforms in China," The Journal of the Economics of Ageing, Elsevier, vol. 11(C), pages 71-92.
    11. Bredenkamp,Caryn & Buisman,Leander Robert, 2015. "Universal health coverage in the Philippines : progress on financial protection goals," Policy Research Working Paper Series 7258, The World Bank.
    12. Jiajing Li & Yanran Huang & Stephen Nicholas & Jian Wang, 2019. "China’s New Cooperative Medical Scheme’s Impact on the Medical Expenses of Elderly Rural Migrants," IJERPH, MDPI, vol. 16(24), pages 1-11, December.
    13. Bergkvist, Sofi & Wagstaff, Adam & Katyal, Anuradha & Singh, Prabal V. & Samarth, Amit & Rao, Mala, 2014. "What a difference a state makes : health reform in Andhra Pradesh," Policy Research Working Paper Series 6883, The World Bank.
    14. Jiannan Li & Bocong Yuan, 2019. "Rural‐urban disparity in risk exposure to involuntary social health insurance transition in China: An investigation of chronic disease patients' mental health problems," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1760-1773, October.
    15. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 32(1), pages 147-189.
    16. Jing You, 2016. "Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 543-558, May.
    17. Chen, Yi & Shi, Julie & Zhuang, Castiel Chen, 2019. "Income-dependent impacts of health insurance on medical expenditures: Theory and evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 290-310.
    18. Feiyan Yang & Li Wei, 2023. "The impact of tax-subsidized health insurance on health and out-of-pocket burden in China," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 194-246, January.

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