The expansion of public health insurance and the demand for private health insurance in rural China

Hong, Liu; Gao, Song; Rizzo, John A.

doi:10.1016/j.chieco.2010.08.006

Cited by 53 publications

(55 citation statements)

References 34 publications

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“…Both evidence has been observed in our data and in other countries [22, 32–36]. On the one hand, our results showed that UEBMI enrollees and high SES population were more likely to buy private insurance.…”

Section: Discussionsupporting

confidence: 91%

Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

2016

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BackgroundChina is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China.MethodsWe used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance.ResultsIn 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage.ConclusionThe migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance.

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Section: Discussionsupporting

confidence: 91%

Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

2016

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“…The NCMS sought to provide low-cost, basic healthcare services, including inpatient, catastrophic, and some types of outpatient care. 28 By the end of 2008, NCMS covered 93 percent of the rural population in China. 29 The NCMS is funded jointly by beneficiaries, county government, and the central government.…”

Section: Ncmsmentioning

confidence: 99%

“…Yet even in 2003, PHI premiums accounted for only 3.6 percent of national healthcare expenditures and 6.3 percent of total insurance revenue. 82 The China Insurance Regulation Commission (CIRC) regulates insurance companies. In terms of total insurance revenue, eight domestic companies controlled 96.3 percent of the market in 2004.…”

Section: Role Of Private Health Insurancementioning

confidence: 99%

Health Insurance in China

Forgia¹,

Burns

2017

China's Healthcare System and Reform

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“…(Query et al, 2007;Parvatiyar & Sheth, 2000). To put it differently, the literature stipulates that, much like other services, motor insurance must also contribute to maximizing the value felt by customers so that they may build a lasting relationship with the company and reveal a loyal behaviour -recommendation, repurchase, preference (Kotler & Armstrong, 2001;Gencer & Akkucuk, 2017).…”

Section: Literature Review and Hypothesis Developmentmentioning

confidence: 99%