China's New Cooperative Medical Scheme's Impact on the Medical Expenses of Elderly Rural Migrants.

Jiajing Li,Yanran Huang,Jian Wang,Stephen Nicholas

doi:10.3390/ijerph16244953

Abstract

Background: With rapid urbanization in China, the scale of elderly migrants from rural areas to urban cities has increased rapidly from 5.03 million in 2000 to 13.4 million people in 2015. Methods: Based on the unbalanced panel data obtained from the Chinese Longitudinal Healthy Longevity Survey, this study investigates the impact of changes to the New Cooperative Medical Scheme (NCMS) on the medical expenditure of Chinese elderly rural migrants by using seemingly unrelated regression models. Results: NCMS coverage for elderly rural migrants rose from 11.83% in 2005 to 87.33% in 2014. The effective reimbursement rate increased significantly from 4.53% in 2005 to 36.44% in 2014, and out-of-pocket/income fell by 50% between 2005 and 2014. The NCMS significantly increased the effective reimbursement rate by 12.4% and out-of-pocket medical expenditure/income by 7.5% during this decade but played an insignificant role in reducing out-of-pocket payments. Conclusions: Policy makers need to promote a two-pronged strategy, which involves controlling the excessive growth of urban medical expenses and continuing to reform NCMS reimbursements for medical treatment, so non-urban resident elderly rural migrants can fully enjoy the welfare benefits of migration and urbanization.

Highlights

Rapid urbanization has seen the growth of Chinese megacities fed by rural-to-urban migration [1].In 1980, only 19.6% of the population in China lived in urban areas but by 2011, the urban population surpassed the rural population
What was the impact of the 2009 New Cooperative Medical Scheme (NCMS) reforms on the health expenditure of elderly rural migrants? By analyzing medical expenses, our study provides an assessment of NCMS policy reforms, including the impact of out-of-pocket (OOP) expenses and reimbursement rates on elderly rural migrants
The descriptive statistics show that the income and medical insurance cover of elderly rural migrants with NCMS increased rapidly between

Summary

Introduction

Rapid urbanization has seen the growth of Chinese megacities fed by rural-to-urban migration [1]. In 1980, only 19.6% of the population in China lived in urban areas but by 2011, the urban population surpassed the rural population. Such hypermigration creates vulnerable populations, including unemployed migrants, young out-of-school migrants, migrant sex workers, illegal child migrant laborers and elderly migrants [2]. The number of elderly migrants—those over 65 years old— increased rapidly. With rapid urbanization in China, the scale of elderly migrants from rural areas to urban cities has increased rapidly from 5.03 million in 2000 to 13.4 million people in 2015

Methods

Results

Discussion

Conclusion