Gender Differences in Health Insurance Coverage in China
Abstract Background: The Chinese government has been trying to build a universal public social health insurance (SHI) system since the early 2000s and has essentially achieved universal SHI coverage. By 2018, more than 97% of the entire Chinese population had SHI. However, there are still some obvious inequities in the SHI system. Methods: based on three datasets, we first use statistical methods to identify gender differences in health insurance. Next, we construct a simple multiple regression model to capture the differences in insurance coverage across age groups using the parameter of interaction terms for gender and age groups.Results: Based on data from a demographic survey that covers a large sample, we find that in the below 50 (in 2005) or 60 (in 2015) years age group, the coverage gap of urban employees' basic medical insurance (UEBMI) between men and women was relatively smaller, while a larger disparity existed in the above 50 (in 2005) or 60 (in 2015) group. Moreover, gender differences in health insurance were more pronounced in the low-education group, while no gender differences were found in the high-education group.Conclusions: This paper explains the gender gap in health insurance and the reason for the wider gap among older people. Our study indicates that because the UEBMI in China mainly covers people with formal jobs, a lower labor participation rate (even much lower in formal jobs) of women has led to their greater difficulty in obtaining health insurance. Since the older women’s greater difficulty in obtaining jobs or susceptibility to lay-offs during the period of the UEBMI’s implementation, the possibility of being covered was even much lower. In fact, it was because of the combined effects of the UEBMI system and the labor market condition at that time that older women had a lower proportion of being covered under the UEBMI.