Equity in health-care financing in China during the progression toward universal health coverage

Zhou, Guoliang; Chen, Ran; Chen, Mingsheng

doi:10.1016/j.chieco.2020.101427

Cited by 11 publications

(4 citation statements)

References 39 publications

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“…Progressivity of OOP healthcare payments varies in other countries within the Asian continent. The OOP payments were progressive in other upper-middle income countries, such as China, similar to Malaysia, the OOP payments were mostly concentrated among the richer households and increased along the household ATP [11]. However, in Iran, the OOP payments were regressive, although the regressivity trend decreased over time, but increasing incidence of CHE indicates inequitable OOP payments [33,34].…”

Section: Discussionmentioning

confidence: 93%

“…Previous studies indicate the OOP payments were regressive in low-income countries such as in Nigeria [8] and lower-middle income countries such as Bangladesh [9] and India [10], indicating a high burden of OOP payments falls on the poor. Other developing middle-income countries, such as China and Iran, made fairly progressive OOP health payments [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

Baharin

Juni

Manaf

2022

IJERPH

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Background: Out-of-pocket (OOP) payments are an inequitable mechanism for health financing as their high share of total health expenditures poses a risk of catastrophic healthcare expenditures. This study aimed to assess the distribution and progressivity of OOP payments made by Malaysian households for various group of healthcare services. Methods: This study utilized data from the Malaysian Household Expenditure Survey (HES) between 2014 and 2015, which involved 14,473 households. Distribution and progressivity of OOP payments were measured through their proportion of household consumption, a concentration curves plot and the Kakwani Progressivity Index (KPI). Results: The mean proportion of Malaysian OOP payments for healthcare of household consumption was 1.65%. The proportion increased across households’ consumption quintiles, from 1.03% made by the poorest 20% to 1.86% by the richest 20%. The OOP payments in Malaysia were progressive with a positive KPI of 0.0910. The OOP payments made for hospital-based services were the most progressive (KPI 0.1756), followed by medical products, appliances and equipment (KPI 0.1192), pharmaceuticals (0.0925) and outpatient-based services (KPI 0.0394) as the least progressive. Conclusions: Overall, the OOP payments for healthcare services in Malaysia were progressive and equitable as they were more concentrated among the richer households.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

Baharin

Juni

Manaf

2022

IJERPH

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“…For example, in a typical dragon year, more births are recorded than other years hence a higher utilization rate. Reference [ 34 ] also explains that the impact of mothers who give birth to twins or triplets is marginal since such persons only receive a marginal increase in maternity insurance benefits which has very minimal impact on the maternity insurance fund balance.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Analysis of Impact of Universal Two-Child Policy on Maternity Insurance Fund in Jiangsu Province and Guangxi Zhuang AR

Antwi

Zhou

et al. 2021

Healthcare

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The maternity insurance fund in some provinces in China has accumulated unprecedented deficit levels. This imminent depletion can cause a catastrophic health crisis for maternal health. This study analyzed the post-policy impact of key factors on maternity insurance income inflow and outflow in Jiangsu Province and Guangxi Zhuang Autonomous Region (AR). We applied Pasera’s ARLD model and VECM Granger Causality Test to establish long- and short-term impact of selected factors that determines the income and expenditure of the maternity insurance fund in the two regions based on data from 2011 to 2019. Our results show that the addition of new births due to the universal two-child policy has increased the per capita utilization of the maternity insurance fund in both areas. We further observed that the impact of the maternity insurance contribution rate to the maternity insurance fund decays with time giving a long-run limited impact in both provinces. Thus the positive impact is stronger in the short term, but in the long term, its influence or contribution to stability of the funds reduces. The positive impact of interest from investment in the maternity insurance fund is however insignificant in both provinces, giving a major cause for concern on its role in maternity insurance fund income generation. In the short term, the contribution rate of the maternity insurance fund must be adjusted upward or the payment base expanded to receive additional contribution from all employees to avoid complete depletion of the fund. In the long term, we recommend the need to replenish the maternity insurance funds through proper investment options for the funds. We further recommend the need to look for other sources of funding social interventions based on existing practices in other countries.

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“…The survey data of the Poverty Alleviation Office of the State council showed that 42% of seven million poor peasants were poor because of illness at the end of 2015 in China (Sohu News Network: Multidimensional Elimination of “poverty due to illness”, 14 January 2016( )). Poverty due to illness is one of the root causes of poverty in rural China, and 51.63% of poor people attribute their poverty to the illness of household members in rural China [ 7 ]. Importantly, health shocks and major diseases, in particular, can impact rural households’ savings not only in the short term, but also in the long term [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Public Health Insurance on Household Credit Availability in Rural China: Evidence from NRCMS

Yang

et al. 2020

IJERPH

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A large body of literature has shown that the burden of healthcare can push individuals and households into the burden of medical care and income loss. This makes it difficult for rural or low-income households to obtain and use safe and affordable formal credit services. In 2003, China’s government implemented a new rural public health insurance, which was called the New Rural Cooperative Medical Scheme (NRCMS). This study provides evidence of the impact of NRCMS on household credit availability using the China Family Panel Studies (CFPS) for 2010. The tobit regression approach and mediator model are used. The results show that, as a public health insurance system sustained by the participation of government investment, the NRCMS provides good “collateral” and significantly enhances rural households’ formal credit availability level. Furthermore, this positive effect is mainly reflected in the economic effect of NRCMS. Our results are robust to alternative statistical methods. Our findings suggest that expanding access, fulfilling the NRCMS mortgage function, and providing more financial services for rural households would have big benefits with regard to easing credit constraints for rural residents.

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Equity in health-care financing in China during the progression toward universal health coverage

Cited by 11 publications

References 39 publications

Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

A Comparative Analysis of Impact of Universal Two-Child Policy on Maternity Insurance Fund in Jiangsu Province and Guangxi Zhuang AR

The Impact of Public Health Insurance on Household Credit Availability in Rural China: Evidence from NRCMS

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