The effects of public health insurance expansion on private health insurance in urban China
Tóm tắt
The public social health insurance coverage has rapidly increased in China in the last decade. The rapid market development and high economic growth also present an immense opportunity for the private insurance market. This paper uses the China Health and Nutrition Survey panel data and the difference-in-difference method to identify the causal effects of public health insurance expansion on private health insurance development in the case of expansion of the China Urban Residential Basic Medical Insurance (URBMI) program. The paper finds private health insurance enrollment is not affected by the introduction and expansion of URBMI. Rather, private health insurance plays supplementary roles. The findings present the challenges and opportunities for public policies to develop and regulate private health insurance to meet the market niches and provide health insurance to the demands of a heterogeneous population. The findings also have broader implications for other developing nations where public health insurance intends to rapidly expand towards the universal health coverage.
Tài liệu tham khảo
Angrist, J. D., & Pischke, J.-S. (2009). Mostly harmless econometrics: An empiricist’s companion. Princeton: Princeton University Press.
Berenson, R. A., & Dowd, B. E. (2008). Medicare advantage plans at a crossroads—Yet again. Health Affairs. doi:10.1377/hlthaff.28.1.w29.
Bleakley, H. (2007). Disease and development: Evidence from hookworm eradication in the American South. The Quarterly Journal of Economics, 122(1), 73–117.
Carrin, G., Ron, A., Wang, H., & Zhang, S. (1999). The reform of the rural cooperative medical system in the People’s Republic of China: Interim experience in 14 pilot counties. Social Science and Medicine, 48(7), 961–972.
Chen, W. (2009). The commercial medical insurance and supplemental insurance. Chinese Medical Resources, 3, 135–137.
Colombo, F., & Tapay, N. (2004). Private health insurance in OECD countries: The benefits and costs for individuals and health systems. OECD health working papers no. 15. Paris: Organisation for Economic Co-operation and Development.
Costa, J., & Garcia, J. (2003). Demand for private health insurance: How important is the quality gap? Health Economics. doi:10.1002/hec.756.
Cutler, D. M., & Gruber, J. (1996). Does public insurance crowd out private insurance? Quarterly Journal of Economics, 111(2), 391–430. http://qje.oxfordjournals.org/content/by/year.
Dong, K. (2009). Medical insurance system evolution in China. China Economic Review, 20(4), 591–597.
Drechsler, D., & Jütting, J. (2007). Different countries, different needs: The role of private health insurance in developing countries. Journal of Health Politics, Policy and Law, 32(3), 497–534.
Dubay, L., & Kenny, G. (1997). Did medicaid expansions for pregnant women crowd out private coverage? Health Affairs, 16(1), 185–193.
Duflo, E. (2001). Schooling and labor market consequences of school construction in Indonesia: Evidence from an unusual policy experiment. American Economic Review, 91(4), 795–813.
Gruber, J., & Simon, K. (2008). Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance? Journal of Health Economics, 27, 201–217. doi:10.1016/j.jhealeco.2007.11.004.
Hu, T., & Ying, X. (2008). China. In A. Preker, P. Zweifel, & O. Schellekens (Eds.), Global market place for private health insurance, strength in numbers. Washington, DC: The World Bank Group.
Liu, H., Gao, S., & Rizzo, J. A. (2011). The expansion of public health insurance and the demand for private health insurance in rural China. China Economic Review, 22(1), 28–41.
Liu, T., & Chen, C. (2002). An analysis of private health insurance purchasing decisions with national health insurance in Taiwan. Social Science and Medicine, 55, 755–774.
Ministry of Health. (2004). An analysis report of the National Health Service Survey in China, 2003. Center for Health Statistics and Information, Ministry of Health, People’s Republic of China. http://www.nhfpc.gov.cn/cmsresources/mohwsbwstjxxzx/cmsrsdocument/doc9908.pdf. Accessed on December 25, 2013
Ministry of Health. (2009). An analysis report of the National Health Service Survey in China, 2008. Center for Health Statistics and Information, Ministry of Health, People’s Republic of China. http://www.nhfpc.gov.cn/cmsresources/mohwsbwstjxxzx/cmsrsdocument/doc9911.pdf. Accessed on December 25, 2013.
Ministry of Labor and Social Security. (1999). Document number 4. Interim measures on the issuance of the basic medical insurance for urban employees designated medical institutions to manage notifications. Beijing: Minister of Labor and Social Security.
Ministry of Labor and Social Security. (2003). The coverage expansion notice to further improve the basic medical insurance for urban worker. Beijing: Minister of Labor and Social Security.
Propper, C. (1989). An econometric analysis of the demand for private health insurance in England and Wales. Applied Economics, 21(6), 777.
Sekhri, N., & Savedoff, W. (2005). Private health insurance: Implications for developing countries. Bull World Health Organ, 83(2), 127–134.
Shanghai Landseed Hospital. (2015). Partnership with private health insurnace. http://www.landseedhospital.com.cn/mp.asp?mp=hx. Accessed March 10, 2015.
Shore-Sheppard, L., Buchmueller, T. C., & Jensen, G. A. (2000). Medicaid and crowding out of private insurance: A re-examination using firm level data. Journal of Health Economics, 19(1), 61–91.
State Council . (1998). State Council Policy Document 1998 No. 44. The decision to establish the Urban Employee Basic Medical Insurance. State Council, Beijing, China. http://www.gov.cn/banshi/2005-08/04/content_20256.htm. Accessed January 1, 2015.
State Council. (2007). State Council Policy Document 2007 No. 20. Pilot reforms on developing urban resident basic medical insurance. State Council, People’s Republic of China.
The Insurance Act. (2010). The insurance act, People’s Repubic of China. http://www.gov.cn/zxft/ft209/content_1748773.htm. Accessed March 1, 2015.
Wagstaff, A., & Lindelow, M. (2008). Can insurance increase financial risk? The curious case of health insurance in China. Journal of Health Economics, 27(4), 990–1005.