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Effects of NCMS Coverage on Access to Care and Financial Protection in China

Author

Listed:
  • Zhiyuan Hou

    (Shandong University, Jinan, China)

  • Ellen Van de Poel

    (Erasmus University Rotterdam, Netherlands)

  • Eddy Van Doorslaer

    (Erasmus University Rotterdam, Netherlands)

  • Baorong Yua

    (Shandong University, Jinan, China)

  • Qingyue Menge

    (Peking University, China)

Abstract

This discussion paper led to a publication in 'Health Economics' , 2014, 23(8), 917-934. The introduction of the New Cooperative Medical Scheme in rural China is one of the largest health care reforms in the developing world since the 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 Ningxia and Shandong province and adopts an instrumenting approach to estimate the effect of a continuous measure of coverage level. Our results confirm earlier findings of NCMS being effective in increasing access to care, but not increasing financial protection. In addition, we find that NCMS enrollees are sensitive to the incentives set in the NCMS design when choosing their provider, but also that providers seem to respond by increasing prices and/or providing more expensive care.

Suggested Citation

  • Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yua & Qingyue Menge, 2012. "Effects of NCMS Coverage on Access to Care and Financial Protection in China," Tinbergen Institute Discussion Papers 12-039/3, Tinbergen Institute.
  • Handle: RePEc:tin:wpaper:20120039
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    File URL: http://papers.tinbergen.nl/12039.pdf
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    References listed on IDEAS

    as
    1. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, Oxford University Press, vol. 119(1), pages 249-275.
    2. Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
    3. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
    4. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    5. You, Xuedan & Kobayashi, Yasuki, 2009. "The new cooperative medical scheme in China," Health Policy, Elsevier, vol. 91(1), pages 1-9, June.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Keywords

    Health insurance; access; financial protection; China;

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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