IDEAS home Printed from https://ideas.repec.org/p/rtv/ceisrp/296.html
   My bibliography  Save this paper

The health care system reform in China: effects on out-of-pocket expenses and saving

Author

Listed:

Abstract

This paper aims at evaluating the impact of 1998 Chinese health care reform on out-of-pocket expenditure and on saving. Existing evidence on the results achieved by this reform in terms of reduction of out-of-pocket medical expenditures is still mixed and contradictory, and very little is known about the impact of these measures on the consumption and saving behavior of the Chinese population. To shed more light on this issue we use data collected by the Chinese Household Income Project (CHIP), through a series of questionnaire-based interviews conducted in urban areas in 1995 and 2002. Contrary to previous evidence, our ndings suggest that, once properly accounting for unobserved heterogeneity (health status), out-of-pocket medical expenses and saving rate are affected by the reform in a differentiated way. In particular, we find that out-of-pocket expenses increase more for individuals with poor health status and the saving rate increases only for individual with good health status.

Suggested Citation

  • Vincenzo Atella & Agar Brugiavini & Noemi Pace, 2013. "The health care system reform in China: effects on out-of-pocket expenses and saving," CEIS Research Paper 296, Tor Vergata University, CEIS, revised 22 Oct 2013.
  • Handle: RePEc:rtv:ceisrp:296
    as

    Download full text from publisher

    File URL: ftp://www.ceistorvergata.it/repec/rpaper/RP296.pdf
    File Function: Main text
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Malhar S Nabar, 2011. "Targets, Interest Rates, and Household Saving in Urban China," IMF Working Papers 11/223, International Monetary Fund.
    2. Franco Modigliani & Shi Larry Cao, 2004. "The Chinese Saving Puzzle and the Life-Cycle Hypothesis," Journal of Economic Literature, American Economic Association, vol. 42(1), pages 145-170, March.
    3. Pudney, Stephen, 2008. "Heaping and leaping: survey response behaviour and the dynamics of self-reported consumption expenditure," ISER Working Paper Series 2008-09, Institute for Social and Economic Research.
    4. Aaberge, Rolf & Zhu, Yu, 2001. "The Pattern of Household Savings during a Hyperinflation: The Case of Urban China in the Late 1980s," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 47(2), pages 181-202, June.
    5. Zhong Zhao, 2008. "Health demand and health determinants in China," Journal of Chinese Economic and Business Studies, Taylor & Francis Journals, vol. 6(1), pages 77-98.
    6. Steven A Barnett & Ray Brooks, 2010. "China; Does Government Health and Education Spending Boost Consumption?," IMF Working Papers 10/16, International Monetary Fund.
    7. Xin Wang & Yi Wen, 2011. "Can rising housing prices explain China’s high household saving rate?," Review, Federal Reserve Bank of St. Louis, issue Mar, pages 67-88.
    8. Orazio P. Attanasio & Guglielmo Weber, 2010. "Consumption and Saving: Models of Intertemporal Allocation and Their Implications for Public Policy," Journal of Economic Literature, American Economic Association, vol. 48(3), pages 693-751, September.
    9. Perkins, Dwight H., 2012. "Rapid growth and changing economic structure: The expenditure side story and its implications for China," China Economic Review, Elsevier, vol. 23(3), pages 501-511.
    10. Guonan Ma & Wang Yi, 2010. "China’s High Saving Rate: Myth and Reality," International Economics, CEPII research center, issue 122, pages 5-39.
    11. Shang-Jin Wei & Xiaobo Zhang, 2011. "The Competitive Saving Motive: Evidence from Rising Sex Ratios and Savings Rates in China," Journal of Political Economy, University of Chicago Press, vol. 119(3), pages 511-564.
    12. Chow, Gregory C, 1985. "A Model of Chinese National Income Determination," Journal of Political Economy, University of Chicago Press, vol. 93(4), pages 782-792, August.
    13. Ya Ping Wang, 2000. "Social and Spatial Implications of Housing Reform in China," International Journal of Urban and Regional Research, Wiley Blackwell, vol. 24(2), pages 397-417, June.
    14. Emanuele Baldacci & Ding Ding & David Coady & Giovanni Callegari & Pietro Tommasino & Jaejoon Woo & Manmohan S. Kumar, 2010. "Public Expenditures on Social Programs and Household Consumption in China," IMF Working Papers 10/69, International Monetary Fund.
    15. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    16. Richard Herd & Hu-Wei Hu & Vincent Koen, 2010. "Providing Greater Old-Age Security in China," OECD Economics Department Working Papers 750, OECD Publishing.
    17. Feng, Jin & He, Lixin & Sato, Hiroshi, 2011. "Public pension and household saving: Evidence from urban China," Journal of Comparative Economics, Elsevier, vol. 39(4), pages 470-485.
    18. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    19. Yingyi Qian, 1988. "Urban and Rural Household Saving in China," IMF Staff Papers, Palgrave Macmillan, vol. 35(4), pages 592-627, December.
    20. Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
    21. Aart Kraay, 2000. "Household Saving in China," World Bank Economic Review, World Bank Group, vol. 14(3), pages 545-570, September.
    22. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    23. Choukhmane, Taha & Coeurdacier, Nicolas & Jin, Keyu, 2013. "The One-Child Policy and Household Savings," CEPR Discussion Papers 9688, C.E.P.R. Discussion Papers.
    24. Wang, Yan, 1995. "Permanent Income and Wealth Accumulation: A Cross-Sectional Study of Chinese Urban and Rural Households," Economic Development and Cultural Change, University of Chicago Press, vol. 43(3), pages 523-550, April.
    25. Vincenzo Atella & Partha Deb, 2013. "Heterogeneity in Long Term Health Outcomes of Migrants within Italy," NBER Working Papers 19422, National Bureau of Economic Research, Inc.
    26. Liu, Yuanli, 2002. "Reforming China's urban health insurance system," Health Policy, Elsevier, vol. 60(2), pages 133-150, May.
    27. Erich Battistin, 2002. "Errors in Survey Reports of Consumption Expenditures," 10th International Conference on Panel Data, Berlin, July 5-6, 2002 C4-2, International Conferences on Panel Data.
    28. Richard J. Buttimer Jr. & Anthony Yanxiang Gu & Tyler T. Yang, 2004. "The Chinese Housing Provident Fund," International Real Estate Review, Asian Real Estate Society, vol. 7(1), pages 1-30.
    29. Giulia Cifaldi & Andrea Neri, 2013. "Asking income and consumption questions in the same survey: what are the risks?," Temi di discussione (Economic working papers) 908, Bank of Italy, Economic Research and International Relations Area.
    30. Gao, Jun & Raven, Joanna H. & Tang, Shenglan, 2007. "Hospitalisation among the elderly in urban China," Health Policy, Elsevier, vol. 84(2-3), pages 210-219, December.
    31. Yu-Wei Hu & Gregorio Impavido & Xiaohong Li, 2009. "Governance and Fund Management in the Chinese Pension System," IMF Working Papers 09/246, International Monetary Fund.
    32. Carrin, Guy & Ron, Aviva & Hui, Yang & Hong, Wang & Tuohong, Zhang & Licheng, Zhang & Shuo, Zhang & Yide, Ye & Jiaying, Chen & Qicheng, Jiang & Zhaoyang, Zhang & Jun, Yu & Xuesheng, Li, 1999. "The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties," Social Science & Medicine, Elsevier, vol. 48(7), pages 961-972, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:taf:chosxx:v:32:y:2017:i:5:p:638-658 is not listed on IDEAS

    More about this item

    Keywords

    China; Health Insurance; Health care system reform; Household Saving; Out-of-pocket expenditures.;

    JEL classification:

    • D14 - Microeconomics - - Household Behavior - - - Household Saving; Personal Finance
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • P36 - Economic Systems - - Socialist Institutions and Their Transitions - - - Consumer Economics; Health; Education and Training; Welfare, Income, Wealth, and Poverty

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:rtv:ceisrp:296. 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: (Barbara Piazzi). General contact details of provider: http://edirc.repec.org/data/csrotit.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.