Dataset Information

Effect of Major Illness Insurance on Vulnerability to Poverty: Evidence From China.

ABSTRACT: Disease is the primary cause of poverty in China. Health insurance is an essential mechanism for managing health risks and addressing the risk of financial loss. Using data from the China Family Panel Studies (CFPS) waves from 2010 to 2016, this study develops a random forest method to assess households' vulnerability to poverty and then examines the impact of major illness insurance on vulnerability to poverty by focusing on the rollout period of a major illness insurance scheme. The research also examines the impact of increased major illness insurance coverage on poverty reduction by focusing on the change from low- to high-coverage health insurance. The findings indicate that major illness insurance and improvements in the degree of coverage significantly reduce vulnerability to poverty. In addition, major illness insurance is found to alleviate the vicious cycle of poverty and disease through the mechanism of increasing household income, and its effect has strengthened over time. Compared to other poverty reduction policies, major illness insurance has a greater influence on poverty alleviation.

SUBMITTER: Zheng L

PROVIDER: S-EPMC8733306 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Effect of Major Illness Insurance on Vulnerability to Poverty: Evidence From China.

Zheng Lili L Peng Lijin L

Frontiers in public health 20211223

Disease is the primary cause of poverty in China. Health insurance is an essential mechanism for managing health risks and addressing the risk of financial loss. Using data from the China Family Panel Studies (CFPS) waves from 2010 to 2016, this study develops a random forest method to assess households' vulnerability to poverty and then examines the impact of major illness insurance on vulnerability to poverty by focusing on the rollout period of a major illness insurance scheme. The research a ...[more]

PMID: 35004594

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Project description:BackgroundIn 2016, the Chinese government introduced an integration reform of the health insurance system with the aim to enhance equity in healthcare coverage and reduce disparities between urban and rural sectors. The gradual introduction of the policy integrating urban and rural medical insurance in pilot cities provides an opportunity to evaluate the policy impact. This study attempts to assess the policy impact of urban-rural health insurance integration on the chronic poverty of rural residents and to analyze the mechanisms.MethodBased on the four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, we employed a staggered difference-in-differences (staggered DID) model to assess the impact of integrating urban-rural health insurance on poverty vulnerability among rural inhabitants and a mediation model to analyze the mechanism channel of the policy impact.Results(1) Baseline regression analysis revealed that the urban-rural health insurance integration significantly reduced the poverty vulnerability of rural residents by 6.32% (p < 0.01). The one health insurance system with one unified scheme of contributions and benefits package (OSOS, 6.27%, p < 0.01) is more effective than the transitional one health insurance system with multiple schemes (OSMS, 3.25%, p < 0.01). (2) The heterogeneity analysis results showed that the urban-rural health insurance integration had a more significant impact on vulnerable groups with relatively poor health (7.84%, p < 0.1) than those with fairly good health (6.07%, p < 0.01), and it also significantly reduced the poverty vulnerability of the group with chronic diseases by 9.59% (p < 0.01). The integration policy can significantly reduce the poverty vulnerability of the low consumption and low medical expenditure groups by 8.6% (p < 0.01) and 7.64% (p < 0.01), respectively, compared to their counterparts. (3) The mechanism analysis results showed that the urban-rural health insurance integration can partially enhance labor supply (14.23%, p < 0.01) and physical examinations (6.28%, p < 0.01). The indirect effects of labor supply and physical examination in reducing poverty vulnerability are 0.14%, 0.13% respectively.ConclusionThe urban-rural health insurance integration policy significantly reduced poverty vulnerability, and the OSOS is more effective than the OSMS. The urban-rural health insurance integration policy can significantly reduce poverty vulnerability for low consumption and poor health groups. Labor supply and physical examination are indirect channels of the impact. Both channels potentially increase rural household income and expectations of investment in human health capital to achieve the policy objective of eliminating chronic poverty.

Project description:BackgroundSouth Africa has a dual system of healthcare model differentiated across socio-economic lines. While on the one hand there exists high quality private facilities that is expensive and accessible to the minority, on the other is the free but stretched and over-crowded public healthcare that the rest of the population relies on. Accessing private facilities requires private medical insurance or requires coping strategies that can lead to household vulnerability.ObjectiveThe objective of this study is to analyse the relationship between health shocks and household vulnerability in the South African context of high poverty and low medical insurance penetration rate.DataThe study employs data from waves three to five of South Africa's nationally representative National Income Dynamics Study (NIDS) conducted between the period 2012-2017 in approximately two-year intervals.MethodsUsing food expenditure shock as an indicator for vulnerability, the study utilises a range of econometric techniques from panel logit regression to quasi-experimental design based difference in difference regressions to assess the association between health shocks, medical insurance and household vulnerability.FindingsThe main finding of the study is that a significant proportion of households in the upper income quintile utilise private healthcare even when not covered by private medical insurance. This preference for private over public health facilities make them vulnerable to health shocks as they cope by sacrificing food consumption to incur additional health expenditure. In contrast, lower income households that are unable to access the high-cost private healthcare tend to rely on the strained public healthcare system. They are not able to use their constrained food expenditure as a coping strategy for private or out-of-pocket medical expenses because their food consumption is already at a bare minimum.ConclusionThe results confirm that access to quality healthcare is a privilege in South Africa, available only to the minority of the population. The study paints a grim picture of household vulnerability in South Africa and underlines the need for a National Health Insurance that would enable universal access to quality healthcare in the country.

Dataset Information

Effect of Major Illness Insurance on Vulnerability to Poverty: Evidence From China.

Publications

Effect of Major Illness Insurance on Vulnerability to Poverty: Evidence From China.

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