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The Impact of the Medical Insurance System on the Health of Older Adults in Urban China: Analysis Based on Three-Period Panel Data

Author

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  • Hongfeng Zhang

    (School of Public Administration and Policy, Shandong University of Finance and Economics, Jinan 250014, China)

  • Peng Cheng

    (School of Public Administration and Policy, Shandong University of Finance and Economics, Jinan 250014, China)

  • Lu Huang

    (School of Economics, Shandong University of Finance and Economics, Jinan 250014, China)

Abstract

The impact of the medical insurance system (MIS) on the health of older adults is a key element of research in the field of social security. Because China’s MIS consists of different types of insurance, and the benefits and levels of coverage received by participating in different medical insurance vary, different medical insurance may have a differential impact on the health of older adults. This has rarely been studied before. In this paper, the panel data of the third phase of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015 and 2018 were used to investigate the impact of participation in social medical insurance (SMI) and commercial medical insurance (CMI) on the health of urban older adults and its mechanism relationship. The study found that SMI had a positive impact on the mental health of older adults, but only in the eastern region. Participation in CMI was positively correlated with the health of older adults, but this association was relatively small and was only observed in the sample of older adults aged 75 years and above. In addition, future life security plays an important role in the process of improving the health of older adults through medical insurance. Both research hypothesis 1 and research hypothesis 2 were verified. The results of this paper show that the evidence of the positive effect of medical insurance on the health of older adults in urban areas proposed by scholars is not convincing enough. Therefore, the medical insurance scheme should be reformed, focusing not only on coverage, but on enhancing the benefits and level of insurance, so as to enhance its positive impact on the health of older adults.

Suggested Citation

  • Hongfeng Zhang & Peng Cheng & Lu Huang, 2023. "The Impact of the Medical Insurance System on the Health of Older Adults in Urban China: Analysis Based on Three-Period Panel Data," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:3817-:d:1075611
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    References listed on IDEAS

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    1. Hongfeng Zhang & Lu Huang & Yan Zhu & Hongyun Si & Xu He, 2021. "Does Low-Carbon City Construction Improve Total Factor Productivity? Evidence from a Quasi-Natural Experiment in China," IJERPH, MDPI, vol. 18(22), pages 1-21, November.
    2. Yanran Chen & Xuezheng Qin, 2022. "The Impact of Extreme Temperature Shocks on the Health Status of the Elderly in China," IJERPH, MDPI, vol. 19(23), pages 1-21, November.
    3. Dunlop, D.D. & Song, J. & Lyons, J.S. & Manheim, L.M. & Chang, R.W., 2003. "Racial/Ethnic Differences in Rates of Depression among Preretirement Adults," American Journal of Public Health, American Public Health Association, vol. 93(11), pages 1945-1952.
    4. Feng Huang & Li Gan`, 2017. "The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 149-163, February.
    5. Niels Skipper, 2013. "On The Demand For Prescription Drugs: Heterogeneity In Price Responses," Health Economics, John Wiley & Sons, Ltd., vol. 22(7), pages 857-869, July.
    6. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    7. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    8. Daysal, N. Meltem, 2012. "Does uninsurance affect the health outcomes of the insured? Evidence from heart attack patients in California," Journal of Health Economics, Elsevier, vol. 31(4), pages 545-563.
    9. Wilper, A.P. & Woolhandler, S. & Lasser, K.E. & McCormick, D. & Bor, D.H. & Himmelstein, D.U., 2009. "Health insurance and mortality in US adults," American Journal of Public Health, American Public Health Association, vol. 99(12), pages 2289-2295.
    10. Lijuan Zhao & Lin Wu, 2022. "The Association between Social Participation and Loneliness of the Chinese Older Adults over Time—The Mediating Effect of Social Support," IJERPH, MDPI, vol. 19(2), pages 1-17, January.
    11. Bocong Yuan & Jiannan Li & Wenqi Liang, 2022. "The interaction of delayed retirement initiative and the multilevel social health insurance system on physical health of older people in China," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 452-464, January.
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    Cited by:

    1. Nina Tumosa, 2023. "Using the Age-Friendly Health Systems Framework to Track Wellness and Health Promotion Priorities of Older Adults in the Global Community," IJERPH, MDPI, vol. 20(5), pages 1-5, March.
    2. Kathryn O’Keefe & Meiyan Chen & Kevin J. Lesser & Adam S. DuVall & Alexander T. Dils, 2024. "Treating Mental Health and Quality of Life in Older Cancer Patients with Cognitive Behavioral Therapy: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 21(7), pages 1-12, July.

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