Extending Health Insurance To The Rural Population : An Impact Evaluation Of China's New Cooperative Medical Scheme

Abstract

In 2003, China launched a heavily subsidized voluntary health insurance program for rural residents. We analyze factors affecting enrollment and combine differences-in-differences with matching methods to obtain impact estimates. We use data collected from program administrators, health facilities and households. Enrollment is lower among poor households, and higher among households with chronically sick members. The scheme has increased outpatient and inpatient utilization (by 20-30%), but has had no impact on out-of-pocket spending or on utilization among the poor. The program has increased ownership of expensive equipment among central township health centers but has had no impact on cost per case.

The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia

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The effects of access to health insurance: Evidence from a regression discontinuity design in Peru

“…She finds that when doctors expect to obtain a proportion of patients' drug expenditures, then they write more expensive prescriptions to insured patients. Wagstaff et al (2009) find that the launch of a heavily subsidized voluntary health insurance program in the rural parts of the country led to increased outpatient and inpatient utilization, but has not reduced out-of-pocket expenditures.…”

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“…As mortality in older populations is less sensitive to income, our implied income-mortality elasticity is much lower, though the marginal effects of the income shock are similar. that the NCMS enrollment has led to an improvement in physical and cognitive function of the elderly; however, most studies find little or only modest evidence that the NCMS or the basic public health insurance program in urban China have reduced out-of-pocket health expenditure (Wagstaff et al, 2009;Lei and Lin, 2009;Sun et al, 2009;Babiarz et al, 2012;Liu and Zhao, 2014;Cheng et al, 2015). The rising health care costs become an urgent challenge to the government.…”