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Effects of China’s Rural Insurance Scheme on Objective Measures of Health


  • Slawa Rokicki
  • Katherine Donato


In 2003, the Chinese government established the New Cooperative Medical Scheme (NCMS) with the goal of improving health for the country’s 800 million mostly uninsured rural residents. Using new data on objective health measures, we analyzed the program’s effectiveness in improving health for enrollees. Using longitudinal data from the China Health and Nutritional Survey from 2000 to 2009 (12 080 observations across four waves), we analyzed the impact of the NCMS on objective measures of health such as blood pressure, HbA1c, and cholesterol, as well as use of preventive care. In order to overcome inherent selection bias where less healthy people are more likely to enroll in the voluntary health insurance scheme, we used intent-to-treat and instrumental variable analysis strategies, and offered evidence that these approaches can mitigate this bias. For every additional year of NCMS coverage, the probability of seeking preventive health care increased by 0.6 percentage points (95% CI 0.1-1.0). However, we did not find evidence that the NCMS resulted in consistent improvements in objective measures of health. Sub-group analysis suggested that lower-income communities benefited more from the program, implying that the program may have resulted in some lessening of the wealth-based disparity in health. The NCMS does not appear to significantly improve objective measures of health. This is consistent with evaluations of health insurance programs in other countries, but in contrast to some previously reported improvements in self-reported health resulting from the NCMS.

Suggested Citation

  • Slawa Rokicki & Katherine Donato, 2016. "Effects of China’s Rural Insurance Scheme on Objective Measures of Health," Economics Working Papers 16-01, Queen's Management School, Queen's University Belfast.
  • Handle: RePEc:qub:wpaper:1601

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    1. Zhang, Linxiu & Wang, H. Holly & Rozelle, Scott & Yan, Yuanyuan, 2006. "Insuring Rural China's Health? An Empirical Analysis of China's New Cooperative Medical System," 2006 Annual Meeting, August 12-18, 2006, Queensland, Australia 25586, International Association of Agricultural Economists.
    2. 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.
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    Cited by:

    1. 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.

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    More about this item


    China; Health insurance; Biomarkers; Objective health;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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