Health Insurance Coverage of Migrant Workers in China

Abstract Objective: To review China’s healthcare policies and their applications to rural-to-urban migrant workers (RUMWs) in China, to identify problems faced by RUMWs and the policy gaps that need to be addressed in future, and to facilitate better implementation of the UHC on RUMWs. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total 71 articles were reviewed. Findings: (1) Chinese RUMWs have a high work mobility and low job stability; (2) Barriers faced by RUMWs to have effective health insurance coverage are mainly due to the reluctancy of employers to provide insurance for all employees and a disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote the effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision over employers, and (5) providing more vocational trainings and other supports to increase RUMW’s job stability.

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Hukou and Health Insurance Coverage for Migrant Workers

Journal of Current Chinese Affairs ◽

10.1177/186810261604500203 ◽

2016 ◽

Vol 45 (2) ◽

pp. 53-82 ◽

Cited By ~ 10

Author(s):

Armin Müller

Keyword(s):

Health Insurance ◽

Migrant Workers ◽

Social Protection ◽

Insurance Coverage ◽

Mainland China ◽

Health Insurance Coverage ◽

Health Insurance System ◽

Coverage Problem ◽

Policy Initiatives ◽

Migration Systems

Most migrant workers in mainland China are officially covered by the New Rural Cooperative Medical System (NRCMS), a rural health insurance system that operates in their home communities. The NRCMS and the system of household registration ([Formula: see text], hukou) are tightly linked and systemically interdependent institutions. Migrant workers have difficulties benefitting from this social protection because it remains spatially separated from them. Only a minority have access to urban health insurance systems. This paper sheds light on the institutional origins of the coverage problem of migrant workers and examines crucial policy initiatives that attempt to solve it. In the context of the ongoing hukou reforms, these policies aim to partially dissolve the systemic interdependence of hukou and health insurance. While the policies provide feasible, yet conflict-prone, solutions in short-distance and concentrated bilateral migration systems, covering migrants who cross provincial boundaries remains a challenge.

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Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

10.21203/rs.2.13976/v2 ◽

2020 ◽

Author(s):

Shanquan Chen(Former Corresponding Author) ◽

Yingyao Chen ◽

Zhanchun Feng ◽

Xi Chen ◽

Zheng Wang ◽

...

Keyword(s):

Systematic Review ◽

Health Insurance ◽

Migrant Workers ◽

Gap Analysis ◽

Central Government ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Cochrane Library ◽

Job Stability ◽

Urban Migrant

Abstract Background: More than 90% of the Chinese population was covered by its three basic social health insurances.However, the Chinese rural-to-urban migrant workers (RUMWs), accounting for about one-fifth of China’s total population, seem to be put on a disadvantaged position under the current health insurance schemes. The purpose of this study is to identify the current barriers and to provide policy suggestions to the ineffective health insurance coverage of RUMWs in China. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total, 70 articles were reviewed. Results: (1) Chinese RUMWs have high work mobility and low job stability; (2) Barriers faced by RUMWs in obtaining effective health insurance coverage are primarily due to the reluctance of employers to provide insurance for all employees and the disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision of employers, and (5) providing more vocational training and other support to increase RUMW’s job stability.

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Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

10.21203/rs.2.13976/v3 ◽

2020 ◽

Author(s):

Shanquan Chen ◽

Yingyao Chen ◽

Zhanchun Feng ◽

Xi Chen ◽

Zheng Wang ◽

...

Keyword(s):

Systematic Review ◽

Health Insurance ◽

Migrant Workers ◽

Gap Analysis ◽

Central Government ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Cochrane Library ◽

Job Stability ◽

Urban Migrant

Abstract Background: More than 90% of the Chinese population was covered by its three basic social health insurances. However, the Chinese rural-to-urban migrant workers (RUMWs), accounting for about one-fifth of China’s total population, seem to be put on a disadvantaged position under the current health insurance schemes. The purpose of this study is to identify the current barriers and to provide policy suggestions to the ineffective health insurance coverage of RUMWs in China. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total, 70 articles were reviewed. Results: (1) Chinese RUMWs have high work mobility and low job stability; (2) Barriers faced by RUMWs in obtaining effective health insurance coverage are primarily due to the reluctance of employers to provide insurance for all employees and the disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision of employers, and (5) providing more vocational training and other support to increase RUMW’s job stability.

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