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Inequality of Opportunity in Health Care in China: Suggestion on the Construction of the Urban-Rural Integrated Medical Insurance System

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  • Sun, Jiawei
  • Ma, Chao
  • Song, Ze
  • Gu, Hai

Abstract

This paper investigates the urban-rural inequality of opportunity in health care in China based on the theory of equality of opportunity of Roemer (1998). Following the compensation principle proposed by Fleurbaey and Schokkaert (2011), this paper establishes a decomposition strategy of the fairness gap, which we use for the measurement of the inequality of opportunity in the urban-rural health care use. Empirical analysis using the CHNS data shows that the ratios of the fairness gap to the directly observed average urban-rural difference in health care are 1.167 during 1997-2000 and 1.744 during 2004-2006, indicating that the average urban-rural difference observed directly from original statistical data may underestimate the degree of the essential inequity. Meanwhile, the increasing fairness gap and the decomposition results imply that generally leveling the urban-rural reimbursement ratios is probably not sufficient, and pro-disadvantage policies should be put in place in order to mitigate or even eliminate the inequality of opportunity in health care use between urban and rural residents. The results are also illuminating for the experiments and establishment of the urban-rural integrated medical insurance system (URIMIS) in China. The pro-disadvantage policies will be more appreciated and effective in the promotion of the equality of opportunity in health care, within the background of urban-rural dualistic social structure and widening urban-rural income gap. This suggestion is supported by data from the URIMIS pilot regions in Jiangsu province. The results show that the fairness gap can be narrowed significantly via pro-disadvantage policies.

Suggested Citation

  • Sun, Jiawei & Ma, Chao & Song, Ze & Gu, Hai, 2013. "Inequality of Opportunity in Health Care in China: Suggestion on the Construction of the Urban-Rural Integrated Medical Insurance System," MPRA Paper 49389, University Library of Munich, Germany.
  • Handle: RePEc:pra:mprapa:49389
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    References listed on IDEAS

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    1. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    2. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    3. repec:dau:papers:123456789/1552 is not listed on IDEAS
    4. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
    5. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    6. François Bourguignon & Francisco H. G. Ferreira & Marta Menéndez, 2007. "Inequality Of Opportunity In Brazil," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 53(4), pages 585-618, December.
    7. Alain Trannoy & Sandy Tubeuf & Florence Jusot & Marion Devaux, 2010. "Inequality of opportunities in health in France: a first pass," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 921-938, August.
    8. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    9. Zhang, Yingqiang & Eriksson, Tor, 2010. "Inequality of opportunity and income inequality in nine Chinese provinces, 1989-2006," China Economic Review, Elsevier, vol. 21(4), pages 607-616, December.
    10. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    11. Partha Deb & Pravin K. Trivedi, 2006. "Specification and simulated likelihood estimation of a non-normal treatment-outcome model with selection: Application to health care utilization," Econometrics Journal, Royal Economic Society, vol. 9(2), pages 307-331, July.
    12. Silvia Balia & Andrew M. Jones, 2011. "Catching the habit: a study of inequality of opportunity in smoking‐related mortality," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(1), pages 175-194, January.
    13. Francisco H. G. Ferreira & Jérémie Gignoux, 2011. "The Measurement Of Inequality Of Opportunity: Theory And An Application To Latin America," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 57(4), pages 622-657, December.
    14. Jusot, F & Tubeuf, S & Trannoy, T, 2010. "Inequality of Opportunities in Health in Europe: Why So Much Difference Across Countries?," Health, Econometrics and Data Group (HEDG) Working Papers 10/26, HEDG, c/o Department of Economics, University of York.
    15. David Roodman, 2011. "Fitting fully observed recursive mixed-process models with cmp," Stata Journal, StataCorp LP, vol. 11(2), pages 159-206, June.
    16. Pedro Rosa Dias, 2010. "Modelling opportunity in health under partial observability of circumstances," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 252-264.
    17. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    18. Andrew Jones & Nigel Rice & Pedro Rosa Dias, 2012. "Quality of schooling and inequality of opportunity in health," Empirical Economics, Springer, vol. 42(2), pages 369-394, April.
    19. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.
    20. James J. Heckman & Hidehiko Ichimura & Petra Todd, 1998. "Matching As An Econometric Evaluation Estimator," Review of Economic Studies, Oxford University Press, vol. 65(2), pages 261-294.
    21. repec:dau:papers:123456789/268 is not listed on IDEAS
    22. repec:mpr:mprres:5096 is not listed on IDEAS
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. #HEJC papers for October 2013
      by academichealtheconomists in The Academic Health Economists' Blog on 2013-10-01 04:30:26

    More about this item

    Keywords

    equality of opportunity; health care; fairness gap; urban-rural integrated medical insurance system;

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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