In 2003, a public insurance system was introduced in Chinese rural areas. In the meantime, subjective health status improved. We used a unique household longitudinal survey to analyse how the introduction of an insurance system, known as the New Cooperative Medical Scheme (NCMS), has contributed to the change. This health insurance programme was launched sequentially over counties starting in 2003, and households voluntarily chose whether to participate the programme after its launch by the county. These characteristics make it feasible to disentangle two channels of the influence of the NCMS on self-reported health status. One is the insurance effect of the coverage, which can be estimated by comparing the insured households with non-participants in the villages located in counties that have launched the programme (NCMS counties); the other is the general equilibrium effect that affects all residents in the NCMS counties, and can be estimated by comparing non-participants with the non-exposed households. The longitudinal data also allow us to examine how the effect changes with the duration of households’ subscription to the programme. The empirical findings include: first, a positive extensive margin: an individual feels better about his or her health status when covered by the NCMS. However, there is no intensive margin: there is no additional gain in the self-assessment of health status with the individual’s number of years enrolled in the programme. Second, we find a positive general equilibrium effect of introducing the NCMS programme on non-participants in the NCMS county. This effect accumulates over time.
How Do You Feel? The Effect of the New Cooperative Medical Scheme in China
Résumé
en
In 2003, a public insurance system was introduced in Chinese rural areas. In the meantime, subjective health status improved. We used a unique household longitudinal survey to analyse how the introduction of an insurance system, known as the New Cooperative Medical Scheme (NCMS), has contributed to the change. This health insurance programme was launched sequentially over counties starting in 2003, and households voluntarily chose whether to participate the programme after its launch by the county. These characteristics make it feasible to disentangle two channels of the influence of the NCMS on self-reported health status. One is the insurance effect of the coverage, which can be estimated by comparing the insured households with non-participants in the villages located in counties that have launched the programme (NCMS counties); the other is the general equilibrium effect that affects all residents in the NCMS counties, and can be estimated by comparing non-participants with the non-exposed households. The longitudinal data also allow us to examine how the effect changes with the duration of households’ subscription to the programme. The empirical findings include: first, a positive extensive margin: an individual feels better about his or her health status when covered by the NCMS. However, there is no intensive margin: there is no additional gain in the self-assessment of health status with the individual’s number of years enrolled in the programme. Second, we find a positive general equilibrium effect of introducing the NCMS programme on non-participants in the NCMS county. This effect accumulates over time.
Auteur(s)
Carine Milcent1, 2, 3
, Binzhen Wu4
1
PSE -
Paris School of Economics
( 301309 )
- 48 boulevard Jourdan 75014 Paris
- France
Université Paris 1 Panthéon-Sorbonne ( 7550 )
;
École normale supérieure - Paris ( 59704 )
;
Université Paris Sciences et Lettres ( 564132 )
;
École des hautes études en sciences sociales ( 99539 )
;
École des Ponts ParisTech ( 301545 )
;
Centre National de la Recherche Scientifique ( 441569 )
;
Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement ( 577435 )
2
PSE -
Paris-Jourdan Sciences Economiques
( 139754 )
- 48 boulevard Jourdan 75014 Paris
- France
École normale supérieure - Paris ( 59704 )
;
Université Paris Sciences et Lettres ( 564132 )
;
Institut National de la Recherche Agronomique USC1336 ( 92114 )
;
École des hautes études en sciences sociales ( 99539 )
;
École des Ponts ParisTech ( 301545 )
;
Centre National de la Recherche Scientifique UMR8545 ( 441569 )
3
CEPREMAP -
Centre pour la recherche économique et ses applications
( 300479 )
- Ecole normale supérieure (ENS)
48 boulevard Jourdan, 75014 Paris
- France
Département d'économie de l'ENS-PSL ( 1151928 )
;
École normale supérieure - Paris ( 59704 )
;
Université Paris Sciences et Lettres ( 564132 )
4
School of Economics and Management
( 223029 )
- Chine
Tsinghua University [Beijing] ( 24050 )
Audience
Internationale
Date de publication
2015
Volume
51
Numéro
12
Page/Identifiant
1585-1602
Nom de la revue
The Journal of Development Studies
(ISSN : 0022-0388, ISSN électronique : 1743-9140)
Publié par Taylor & Francis (Routledge)
Revue non référencée dans Sherpa-Romeo
Comité de lecture
Oui
Vulgarisation
Non
Langue du document
Anglais
Domaine(s)
Sciences de l'Homme et Société/Economies et finances
D - Microeconomics/D.D8 - Information, Knowledge, and Uncertainty/D.D8.D82 - Asymmetric and Private Information • Mechanism Design
H - Public Economics/H.H5 - National Government Expenditures and Related Policies/H.H5.H52 - Government Expenditures and Education
I - Health, Education, and Welfare/I.I3 - Welfare, Well-Being, and Poverty/I.I3.I38 - Government Policy • Provision and Effects of Welfare Programs
Financement
Ce travail a bénéficié d'une aide de l'Etat gérée par l'Agence Nationale de la Recherche au titre du programme « Investissements d'avenir » portant la référence ANR-10-LABX-93-01.
This work was supported by the French National Research Agency, through the program Investissements d'Avenir, ANR-10--LABX_93-01
Mots-clés
en
China, Medical Scheme, Subjective health, Rural China, New Cooperative Medical Scheme, Health insurance
Carine Milcent, Binzhen Wu. How Do You Feel? The Effect of the New Cooperative Medical Scheme in China. The Journal of Development Studies, 2015, 51 (12), pp.1585-1602. ⟨10.1080/00220388.2015.1036038⟩. ⟨halshs-01313725⟩