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The effects of economic reform on health insurance and the financial burden for urban workers in China

  • Teh-Wei Hu

    (School of Public Health, University of California, Berkeley, CA, USA)

  • Michael Ong

    (Health Services and Policy Analysis Program, University of California, Berkeley, CA, USA)

  • Zi-Hua Lin

    (School of Public Health, Shanghai Medical University, Shanghai, China)

  • Elizabeth Li

    (Department of Economics, Miami University, Oxford, OH, USA)

Registered author(s):

    Since 1980, Chinese enterprises have been undergoing reforms in employment practice, taxation, and workers' health|welfare benefits coverage. In particular, Chinese businesses have been facing a major challenge with respect to the financial burden of providing medical benefits to their workers. The purpose of this paper is to analyse the impact of enterprise reform on workers' health care benefits and their financial burden due to medical expenses. This study is based on a 1992 survey conducted in 22 cities, and included 406 enterprises and 5920 workers. It was found that there were wide variations of coverage for health care benefits among urban Chinese workers. It was also found that workers with partial coverage were as likely to incur out-of-pocket medical expenditures as workers without coverage. These out-of-pocket medical expenditures could reach as high as 25% of a worker's annual income. Policy recommendations are discussed at the end of the paper. Copyright © 1999 John Wiley & Sons, Ltd.

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    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 8 (1999)
    Issue (Month): 4 ()
    Pages: 309-321

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    Handle: RePEc:wly:hlthec:v:8:y:1999:i:4:p:309-321
    Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. HO, Lok Sang, 1995. "Market reforms and China's health care system," Social Science & Medicine, Elsevier, vol. 41(8), pages 1065-1072, October.
    2. Henderson, Gail & Shuigao, Jin & Akin, John & Zhiming, Li & Jianmin, Wang & Haijiang, Ma & Yunan, He & Xiping, Zhang & Ying, Chang & Keyou, Ge, 1995. "Distribution of medical insurance in China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1119-1130, October.
    3. Gerald S. Goldstein & Mark V. Pauly, 1976. "Group Health Insurance as a Local Public Good," NBER Chapters, in: The Role of Health Insurance in the Health Services Sector, pages 73-114 National Bureau of Economic Research, Inc.
    4. Xing-Yuan, Gu & Sheng-Lan, Tang, 1995. "Reform of the Chinese health care financing system," Health Policy, Elsevier, vol. 32(1-3), pages 181-191.
    5. 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.
    6. 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.
    7. Liu, Xingzhu & Hsiao, William C. L., 1995. "The cost escalation of social health insurance plans in China: Its implication for public policy," Social Science & Medicine, Elsevier, vol. 41(8), pages 1095-1101, October.
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