The effect of health insurance reform: Evidence from China

Abstract

This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey11This research uses data from China Health and Nutrition Survey (CHNS). We should thank the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Centre, the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, and R01-HD38700) and the Fogarty International Centre, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2006 and both parties plus the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009 and future surveys. we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.