Abstract
BackgroundIllness is the leading cause (44%) of poverty in China. Since 2016, The health poverty alleviation project, an integral component of the Targeted Poverty Alleviation in China, was implemented in 2016 to strengthen financial risk protection against illness for financially backward segments of the population. However, the effects of the health poverty alleviation project on financial risk protection have not been explored in the literature, this paper aims to bridge the gap.MethodsUsing panel data on 63,426 rural households in Chishui City, China, from 2014 to 2017, the difference-in-differences with propensity score matching method was employed.ResultsThe health poverty alleviation project reduces out-of-pocket payments by 15% on average and decreases the probability of catastrophic health expenditure (annual out-of-pocket payments exceeding 10% of annual household income) and impoverishing health spending occurrence (out-of-pocket payments are forcing a household into poverty or into deeper poverty) by 7.7 and 11.7%, respectively. Additionally, the project increases the number of annual hospitalizations per household by 0.035.ConclusionOur study demonstrates that the health poverty alleviation project significantly improves financial risk protection by reducing out-of-pocket payments and decreasing the probability of incurring catastrophic or impoverishing levels of health expenditure. Our study has implications for the poverty reduction policies and reform of the Chinese health financing system.
Highlights
The burden imposed by out-of-pocket (OOP) payments for medical treatments results in financial hardship for millions of people in low-and middle-income countries when they seek health care [1,2,3]
Other countries for instance, Vietnam, do provide a public health insurance, but the poor are still required to make a co-payment of 5% of the health care costs [8], while China, provides voluntary health insurance, for which the government subsidizes a substantial part of the premium [9]
We examine whether the extra packages have enhanced the effect on financial risk protection for poverty households
Summary
The burden imposed by out-of-pocket (OOP) payments for medical treatments results in financial hardship for millions of people in low-and middle-income countries when they seek health care [1,2,3]. It is estimated that almost 100 million people are Various interventions attempting to eliminate poverty arising from high OOP payments and to provide financial risk protection to the poor have been introduced by governments and nongovernmental organizations (NGOs). Other countries for instance, Vietnam, do provide a public health insurance, but the poor are still required to make a co-payment of 5% of the health care costs [8], while China, provides voluntary health insurance, for which the government subsidizes a substantial part of the premium (more than 80%) [9]. Since 2016, The health poverty alleviation project, an integral component of the Targeted Poverty Alleviation in China, was implemented in 2016 to strengthen financial risk protection against illness for financially backward segments of the population. In December 2016, the 13th Five-Year (2016–2020) National Plan for Poverty Reduction was formulated, setting explicit objectives and specific tasks for poverty reduction over those 5 years [27]
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