Determinants of Participation in Public Medical Insurance Systems: A Comparison Between Urban and Rural Residents

This paper empirically examined whether participation in the Basic Medical Insurance for Urban and Rural Residents impacted families' allocation to risk assets and risk-free assets using the Heckman two-step method, which is based on the China Household Finance Survey micro data of 2013, 2015, and 2017. The results showed that participation in the Basic Medical Insurance for Urban and Rural Residents can promote families' reasonable choice between risk assets and risk-free assets to a certain extent. To be specific, the risk asset investments are squeezed out for the originally risk-seeking families, while the risk-free asset investments are squeezed out for the originally risk-adverse families. We tested the robustness of the benchmark model and the mediating effect model with different definitions of risk assets and risk-free assets. Also, the analysis of the mechanism showed that this increases families' risk perception—turning their risk attitude more cautious and their investment attitude more rational. To further consolidate the social security attributes of the Basic Medical Insurance for Urban and Rural Residents, behind its high coverage, we should also pay attention to its influence on the investment preferences of families with different social and economic statuses, thereby giving full play to its role in promoting the development of China's financial market. In future research, we can also try to use measurement models such as PSM-DID models, and find the connections and progressive relations between different models, in order to obtain the inquiry results of different dimensions. For the direction of further research in the future, we believe that can be used to test whether the conclusion whose data configuration of the basic medical insurance for family financial assets choice influence is a universal in developing countries, to explore the developing countries to promote the health security system for the influence of its national household financial asset allocation and the corresponding policy recommendations.JEL Classification: D14, G11, H55, I18.

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The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China’s urban and rural residents’ medical insurance

BMC Public Health ◽

10.1186/s12889-021-11367-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xinjie Zhang ◽

Jingru Huang ◽

Ying Luo

Keyword(s):

Medical Insurance ◽

Insurance Fund ◽

Ageing Population ◽

Fertility Intention ◽

Rural Residents ◽

Basic Medical Insurance ◽

Urban And Rural Residents ◽

Child Policy ◽

Insurance Funds ◽

Basic Medical

Abstract Background With the rapid growth of the ageing population, the operating burden of China’s basic medical insurance fund is becoming increasingly heavy. To counter rapid population ageing and ameliorate a series of problems, China has adjusted its fertility policies several times. On January 1, 2016, the universal two-child policy was implemented. This study analysed the impacts of the adjustment to the fertility policy and potential improvements in fertility intention on the insured population and medical insurance fund sustainability. Methods We used an actuarial science method and took the urban and rural residents’ basic medical insurance (URRBMI) of China, which covers most urban and rural residents, as an example to build a dynamic forecast model of population growth and a dynamic actuarial model of medical insurance funds. Results Compared with the original policy, under the current fertility intention (40%) with the universal two-child policy, the ageing of the population structure of URRBMI participants will decline significantly after 2026, and individuals aged 65 and over will account for only 19.01% of the total participants in 2050. The occurrence of the current deficit and accumulated deficit of the URRBMI fund will be postponed for one year to 2022 and 2028, respectively. If fertility intentions continue to rise, the ageing degree of the population structure will decrease, and the deficit would be further delayed. Conclusions The universal two-child policy is conducive to improving the degree of overall population ageing, delaying the occurrence of a URRBMI fund deficit, and improving the sustainability of URRBMI funds. If fertility intention increases, the effects would be stronger. However, since the adjustment of the universal two-child policy has a certain time lag, it will take time to demonstrate this impact. Therefore, while actively promoting the universal two-child policy, other measures should be taken, such as improving the fertility desire among couples of childbearing age and reforming medical insurance payment methods.

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Health financing and integration of urban and rural residents’ basic medical insurance systems in China

International Journal for Equity in Health ◽

10.1186/s12939-017-0690-z ◽

2017 ◽

Vol 16 (1) ◽

Cited By ~ 26

Author(s):

Kun Zhu ◽

Luying Zhang ◽

Shasha Yuan ◽

Xiaojuan Zhang ◽

Zhiruo Zhang

Keyword(s):

Health Financing ◽

Medical Insurance ◽

Rural Residents ◽

Basic Medical Insurance ◽

Urban And Rural Residents ◽

Basic Medical

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Mixed Methods Research on Satisfaction with Basic Medical Insurance for Urban and Rural Residents in China

10.21203/rs.3.rs-15564/v1 ◽

2020 ◽

Author(s):

Xiaofang Liu ◽

Fang Yang ◽

Wenwei Cheng ◽

Yanyan Wu ◽

Jin Cheng ◽

...

Keyword(s):

Latent Variables ◽

Medical Insurance ◽

Public Trust ◽

Perceived Quality ◽

Total Effect ◽

Research Subjects ◽

Rural Residents ◽

Basic Medical Insurance ◽

Urban And Rural Residents ◽

Basic Medical

Abstract Background There are few studies on satisfaction with integrated basic medical insurance for urban and rural residents (URRBMI), and satisfaction is not very high due to the complexity of its policies and differences among the insured. The aim of the present study was to explore the factors that influence satisfaction with URRBMI in China and to provide scientific suggestions for the government to effectively manage and improve the policy.Methods An explanatory sequential design in mixed method research was used. Quantitative study adopted a three-stage stratified cluster sampling method to randomly select the guardians of pupils who had participated in the URRBMI ( n =1335). A quantitative study was conducted to calculate latent variables’ score and path coefficient between latent variables by SmartPLS3. 0. With public trust, public satisfaction and perceived quality as the target variables, the important-performance analysis (IPA) was used to explore the important but insufficient performance factors, which were the key elements to improve satisfaction of URRBMI. A purposeful sampling strategy was used to get qualitative research subjects from quantitative research subjects according to satisfaction level. A qualitative study was conducted using semi-structured interviews and the thematic analysis method was used to summarize the interview data.Results Perceived quality to perceived value with a total effect of 0.676 ( t =31.964, P <0.001), perceived quality to public satisfaction with a total effect of 0.737 ( t =41.270, P <0.001), and public satisfaction to public trust with a total effect of 0.634 ( t =31.305, P <0.001) were three strongest paths. IPA showed that public satisfaction and perceived quality were key factors for public trust and that perceived quality was of high importance and low performance for public satisfaction. The policy quality was a determining factor for perceived quality. Qualitative research showed that the most unsatisfactory aspect for the insured was the policy quality.Conclusions This study found that improving quality is key to improving public satisfaction and public trust. The government should focus on improving and ameliorating the quality of basic medical insurance for urban and rural residents to enhance satisfaction and trust among the insured.

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