The health care system reform in China: Effects on out-of-pocket expenses and saving

Vincenzo Atella, Agar Brugiavini and Noemi Pace

China Economic Review, 2015, vol. 34, issue C, 182-195

Abstract: This paper aims to evaluate the impact of 1998 Chinese health care reform on out-of-pocket expenditure and on saving. Existing evidence on the results achieved by this reform in terms of reduction of out-of-pocket medical expenditures is still mixed and contradictory, and very little is known about the impact of these measures on the consumption and saving behavior of the Chinese population. To shed more light on this issue we use data collected in 1995 and 2002 by the Chinese Household Income Project (CHIP). Contrary to previous evidence, our findings suggest that the effects of the reform have been more articulated and heterogeneous. In fact, we find that once properly accounting for income distribution and unobserved heterogeneity (potentially induced by health status), out-of-pocket medical expenses and saving rate are affected by the reform in a differentiated way. In particular, we find that out-of-pocket expenses decrease only for high income individuals with good health status and the saving rate increases only for low income individuals with good health status. This result is actually worrisome, as it suggests that the public health coverage after the reform provides financial protection only to individuals that are relatively better off (with good health status and/or high income).

Keywords: China; Health insurance; Health care system reform; Household saving; Out-of-pocket expenditures (search for similar items in EconPapers)
JEL-codes: D14 I13 P36 (search for similar items in EconPapers)
Date: 2015
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (8)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S1043951X15000279
Full text for ScienceDirect subscribers only

Related works:
Working Paper: The health care system reform in China: effects on out-of-pocket expenses and saving (2013)
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:eee:chieco:v:34:y:2015:i:c:p:182-195

DOI: 10.1016/j.chieco.2015.02.003

Access Statistics for this article

China Economic Review is currently edited by B.M. Fleisher, K. X. D. Huang, M.E. Lovely, Y. Wen, X. Zhang and X. Zhu

More articles in China Economic Review from Elsevier
Bibliographic data for series maintained by Catherine Liu ().