scholarly journals 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

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.

Reforming Payment Methods for Basic Medical Insurance to Accommodate Traditional Chinese Medicine (TCM) in China : A Case Study of Shaanxi Province

2020 ◽  
Author(s):  
FANG ZHOU ◽  
XIAOHAO ZHANG ◽  
ZHIGUO MA
Keyword(s):  
Medical Insurance ◽  
Diagnosis And Treatment ◽  
Shaanxi Province ◽  
Insurance Fund ◽  
Payment Methods ◽  
Treatment Services ◽  
Basic Medical Insurance ◽  
Medical Institutions ◽  
Insurance Funds ◽  
Basic Medical

Abstract Background: Traditional Chinese medicine (TCM) attaches importance to the philosophy of holism and disease prevention. Meanwhile, costs arising from TCM diagnosis and treatment services are relatively low. Such features cater to the needs of less developed countries and regions to increase the equity and accessibility of medical services and to save basic medical insurance funds. However, China’s current payment system for basic medical insurance fails to fully regard these features, thus unable to incent the demand for and supply of TCM services. Methods: Based on the analysis of the features or rather the advantages of TCM, the article, taking Shaanxi Province located in central China as an example, studies the status quo of economic development, coverage of TCM diagnosis and treatment services by basic medical insurance, implementation of payment methods for basic medical insurance in TCM medical institutions, and aims to explore the reformation of payment methods for basic medical insurance. Results: Statistics have shown that the economic power of Shaanxi Province is below average in China, as a result of which, Shaanxi Province is confronted with a general lack of basic medical insurance fund. On the other hand, the present payment methods for basic medical insurance fail to accommodate the features of TCM. Besides, only a very limited number of TCM medical institutions, service items and medicines are covered by basic medical insurance. Consequently, the advantages of TCM are not exploited to the full in a country that has always treasured TCM. Therefore, reformation in payment methods is pressing. Conclusion: In view of the economic and social development of Shaanxi Province, this article proposes to reform the payment methods for basic medical insurance by introducing a new medicinal-effect-based payment method to accommodate TCM. This payment method has the following four features. Firstly, it advocates strengthening process supervision of diagnosis and treatment activities in medical institutions, establishing a rating system for therapeutic or prophylactic effects, and implementing a reward and punishment mechanism accordingly. Secondly, special audit standards for TCM services shall be determined by the health care department of the people’s government together with the relevant TCM administrative department, more TCM institutions, service items and medicines shall be covered by basic medical insurance, and the negotiation mechanism with medical insurance institutions shall be adjusted. Thirdly, in pricing the fees and standards for TCM services, the price control administrations of the people’s government shall consult TCM experts, and dynamic price adjustments based on costs and professional technical values shall be made. Last but not least, outpatient diagnosis and treatment services shall be covered by basic medical insurance fund, a practice which will not only give full play to the advantages TCM services, but also help reduce the financial burden on patients and save medical insurance funds.

scholarly journals An Empirical Study on the Influence of the Basic Medical Insurance for Urban and Rural Residents on Family Financial Asset Allocation

2021 ◽  
Vol 9 ◽  
Author(s):  
Shenglin Li ◽  
Yifei Yang
Keyword(s):  
Developing Countries ◽  
Asset Allocation ◽  
Medical Insurance ◽  
Mediating Effect ◽  
Financial Asset ◽  
Rural Residents ◽  
Measurement Models ◽  
Basic Medical Insurance ◽  
Urban And Rural Residents ◽  
Basic Medical

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.

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

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.

scholarly journals Construction and application of a revised satisfaction index model for Chinese urban and rural residents basic medical insurance

2020 ◽  
Author(s):  
Wenwei Cheng ◽  
Jin Cheng ◽  
Xiaofang Liu ◽  
Yanyan Wu ◽  
Weichu Sun ◽  
...  
Keyword(s):  
Latent Variables ◽  
Reliability And Validity ◽  
Medical Insurance ◽  
Perceived Quality ◽  
Good Reliability ◽  
Satisfaction Index ◽  
Index Model ◽  
Basic Medical Insurance ◽  
Urban And Rural Residents ◽  
Basic Medical

AbstractBackgroundQuality is the most important factor of satisfaction However, the existing URRBMI index model lacks the decomposition of the connotation of perceived quality and cannot provide a reference for quality improvement and satisfaction promotion.ObjectiveThis study aims to construct a Satisfaction Index Model for Chinese Urban and Rural Residents Basic Medical Insurance (SIM-URRBMI) with accurate and detailed measurement of perceived quality and give a feasible and scientific suggestion for URRBMI or insurance for other countries in the world.MethodsBased on the theoretical framework of The American Customer Satisfaction Index (ACSI), the connotation of perceived quality was refined by literature review and expert consultation to form a pool of alternative measurement variables. A three-stage randomized stratified cluster sampling was adopted to select the main decision makers for pupils’ URRBMI in 8 primary schools from Changsha City. Both Classic Test Theory (CTT) and Item Response Theory (IRT) were used for selection of the measurement variables. The model’s reliability and validity were tested using partial least square (PLS) related methods.ResultsA total of 1909 respondents who had insurance for their children were investigated with the initial questionnaire. The revised SIM-URRBMI consists of 11 latent variables and 28 measurement variables with good reliability and validity. Among the three explanatory variables of public satisfaction, perceived quality had the largest total effect (0.737). The variable with greatest effect among the five first-order latent variables on perceived quality was quality of the medical insurance policy (0.472).ConclusionsThe revised SIM-URRBMI consists of 11 latent variables and 28 measurement variables with good reliability and validity. It provides accurate assessment of perceived quality, which will greatly help performance improvement. Perceived quality is crucial to public satisfaction, especially, the most important aspects are policies regarding medical insurance reimbursement (basic coverage scope, coinsurance, deductible).

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