Making health insurance pro-poor: Evidence from a household panel in rural China
In 2002, China launched the largest public health insurance scheme in the world, the New Cooperative Medical Scheme (NCMS). It is intended to enable rural populations to access health care services, and to curb medical impoverishment. Whether the scheme can reach its equity goals depends on how it i...
| Autores principales: | , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Springer
2015
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/149795 |
| _version_ | 1855518632074805248 |
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| author | Filipski, Mateusz J. Zhang, Yumei Chen, Kevin Z. |
| author_browse | Chen, Kevin Z. Filipski, Mateusz J. Zhang, Yumei |
| author_facet | Filipski, Mateusz J. Zhang, Yumei Chen, Kevin Z. |
| author_sort | Filipski, Mateusz J. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | In 2002, China launched the largest public health insurance scheme in the world, the New Cooperative Medical Scheme (NCMS). It is intended to enable rural populations to access health care services, and to curb medical impoverishment. Whether the scheme can reach its equity goals depends on how it is used, and by whom. Our goal is to shed light on whether and how income levels affect the ability of members to reap insurance benefits. We exploit primary panel data consisting of a complete census (over 3500 individuals) in three villages in Puding County, Guizhou province, collected in 2004, 2006, 2009 and 2011. Data was collected during in-person interviews with household member(s). The data include yearly gross and net medical expenses for all individuals, and socio-economic information. We apply probit, ordinary least squares, and tobit multivariate regression analyses to the three waves in which NCMS was active (2006, 2009 and 2011). Explained variables include obtainment, levels and rates of NCMS reimbursement. Household income is the main explanatory variable, with household- and individual-level controls. We restrict samples to rule out self-selection, and exploit the 2009 NCMS reform to highlight equity-enhancing features of insurance. Prior to 2009 reforms, higher income in our sample was statistically significantly related to higher probability of obtaining reimbursement, as well as higher levels and rates of reimbursement. These relations all disappear after the reform, suggesting lower-income households were better able to reap insurance benefits after the scheme was reformed. Regression results suggest this is partly explained by reimbursement for chronic diseases. The post-reform NCMS distributed benefits more equitably in our study area. Making health insurance pro-poor may require a focus on outpatient costs, credit constraints and chronic diseases, rather than catastrophic illnesses. |
| format | Journal Article |
| id | CGSpace149795 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1497952024-11-15T08:52:14Z Making health insurance pro-poor: Evidence from a household panel in rural China Filipski, Mateusz J. Zhang, Yumei Chen, Kevin Z. insurance income health social protection poverty social safety nets resilience In 2002, China launched the largest public health insurance scheme in the world, the New Cooperative Medical Scheme (NCMS). It is intended to enable rural populations to access health care services, and to curb medical impoverishment. Whether the scheme can reach its equity goals depends on how it is used, and by whom. Our goal is to shed light on whether and how income levels affect the ability of members to reap insurance benefits. We exploit primary panel data consisting of a complete census (over 3500 individuals) in three villages in Puding County, Guizhou province, collected in 2004, 2006, 2009 and 2011. Data was collected during in-person interviews with household member(s). The data include yearly gross and net medical expenses for all individuals, and socio-economic information. We apply probit, ordinary least squares, and tobit multivariate regression analyses to the three waves in which NCMS was active (2006, 2009 and 2011). Explained variables include obtainment, levels and rates of NCMS reimbursement. Household income is the main explanatory variable, with household- and individual-level controls. We restrict samples to rule out self-selection, and exploit the 2009 NCMS reform to highlight equity-enhancing features of insurance. Prior to 2009 reforms, higher income in our sample was statistically significantly related to higher probability of obtaining reimbursement, as well as higher levels and rates of reimbursement. These relations all disappear after the reform, suggesting lower-income households were better able to reap insurance benefits after the scheme was reformed. Regression results suggest this is partly explained by reimbursement for chronic diseases. The post-reform NCMS distributed benefits more equitably in our study area. Making health insurance pro-poor may require a focus on outpatient costs, credit constraints and chronic diseases, rather than catastrophic illnesses. 2015-06-05 2024-08-01T02:49:58Z 2024-08-01T02:49:58Z Journal Article https://hdl.handle.net/10568/149795 en Open Access Springer Filipski, Mateusz J.; Zhang, Yumei; and Chen, Kevin Z. 2015. Making health insurance pro-poor: Evidence from a household panel in rural China. BMC Health Services Research 15: 210. https://doi.org/10.1186/s12913-015-0871-7 |
| spellingShingle | insurance income health social protection poverty social safety nets resilience Filipski, Mateusz J. Zhang, Yumei Chen, Kevin Z. Making health insurance pro-poor: Evidence from a household panel in rural China |
| title | Making health insurance pro-poor: Evidence from a household panel in rural China |
| title_full | Making health insurance pro-poor: Evidence from a household panel in rural China |
| title_fullStr | Making health insurance pro-poor: Evidence from a household panel in rural China |
| title_full_unstemmed | Making health insurance pro-poor: Evidence from a household panel in rural China |
| title_short | Making health insurance pro-poor: Evidence from a household panel in rural China |
| title_sort | making health insurance pro poor evidence from a household panel in rural china |
| topic | insurance income health social protection poverty social safety nets resilience |
| url | https://hdl.handle.net/10568/149795 |
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