Premium Collection and the Problem of Voluntary Enrolment in China's New Rural Cooperative Medical System

Armin Müller ()

Journal of Current Chinese Affairs - China aktuell, 2016, vol. 45, issue 1, 11-41

Abstract: In late 2002, the Chinese government launched an initiative to extend the coverage of health insurance in rural China with the New Rural Cooperative Medical System (NRCMS). It covered all of rural China by 2008 and is being continuously adapted and developed. This study explores two conflicting goals in the policy design: universal coverage and voluntary enrolment. Local governments often faced the problem that only insufficient numbers of villagers were enrolling voluntarily. They developed different strategies to cope with it: Complementary outpatient reimbursement via medical savings accounts (MSAs) effectively transferred villagers’ premiums back to them, thus making the NRCMS more attractive. Adapting the premium-collection process to the local context or utilising collusive practices allowed them to pay premiums on behalf of the villagers from the insurance funds. These strategies undermine the effectiveness of the NRCMS as a risk-pooling mechanism, facilitate latent coverage gaps and turn it into a tax-funded service.

Keywords: China; health system; social policy; local government; New Rural Cooperative Medical System (NRCMS) (search for similar items in EconPapers)
Date: 2016-05
References: Add references at CitEc
Citations:

Downloads: (external link)
http://journals.sub.uni-hamburg.de/giga/jcca/article/view/945 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gig:chaktu:v:45:y:2016:i:1:p:11-41

Ordering information: This journal article can be ordered from
http://www.giga-hamburg.de/china-aktuell

Access Statistics for this article

More articles in Journal of Current Chinese Affairs - China aktuell from Institute of Asian Studies, GIGA German Institute of Global and Area Studies, Hamburg Contact information at EDIRC.
Bibliographic data for series maintained by Karsten Giese () and Heike Holbig ().