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The effects of economic reform on health insurance and the financial burden for urban workers in China

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  • Teh‐Wei Hu
  • Michael Ong
  • Zi‐Hua Lin
  • Elizabeth Li

Abstract

Since 1980, Chinese enterprises have been undergoing reforms in employment practice, taxation, and workers’ health/welfare benefits coverage. In particular, Chinese businesses have been facing a major challenge with respect to the financial burden of providing medical benefits to their workers. The purpose of this paper is to analyse the impact of enterprise reform on workers’ health care benefits and their financial burden due to medical expenses. This study is based on a 1992 survey conducted in 22 cities, and included 406 enterprises and 5920 workers. It was found that there were wide variations of coverage for health care benefits among urban Chinese workers. It was also found that workers with partial coverage were as likely to incur out‐of‐pocket medical expenditures as workers without coverage. These out‐of‐pocket medical expenditures could reach as high as 25% of a worker's annual income. Policy recommendations are discussed at the end of the paper. Copyright © 1999 John Wiley & Sons, Ltd.

Suggested Citation

  • Teh‐Wei Hu & Michael Ong & Zi‐Hua Lin & Elizabeth Li, 1999. "The effects of economic reform on health insurance and the financial burden for urban workers in China," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 309-321, June.
    • Handle: RePEc:wly:hlthec:v:8:y:1999:i:4:p:309-321
    DOI: 10.1002/(SICI)1099-1050(199906)8:4<309::AID-HEC440>3.0.CO;2-N
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    Cited by:

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    2. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    3. Xilong Pan & Hassan H. Dib & Minmin Zhu & Ying Zhang & Yang Fan, 2009. "Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1146-1162, October.
    4. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    5. Hougaard, Jens Leth & Tind, Jørgen, 2009. "Cost allocation and convex data envelopment," European Journal of Operational Research, Elsevier, vol. 194(3), pages 939-947, May.
    6. Joelle H Fong, 2019. "Out-of-pocket health spending among Medicare beneficiaries: Which chronic diseases are most costly?," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-16, September.
    7. Meng, Qingyue & Rehnberg, Clas & Zhuang, Ning & Bian, Ying & Tomson, Goran & Tang, Shenglan, 2004. "The impact of urban health insurance reform on hospital charges: a case study from two cities in China," Health Policy, Elsevier, vol. 68(2), pages 197-209, May.
    8. Zhongwei Zhao & Hongbo Jia & Mengxue Chen, 2020. "Major Socioeconomic Driving Forces of Improving Population Health in China: 1978–2018," Population and Development Review, The Population Council, Inc., vol. 46(4), pages 643-676, December.
    9. Du, Juan, 2009. "Economic reforms and health insurance in China," Social Science & Medicine, Elsevier, vol. 69(3), pages 387-395, August.
    10. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    11. Hendrik P. van Dalen, 2006. "When Health Care Insurance does not make a Difference – The Case of Health Care ‘Made in China’," Tinbergen Institute Discussion Papers 06-091/1, Tinbergen Institute.
    12. Wu, Ming & Xin, Ying & Wang, Huihui & Yu, Wei, 2005. "Private and public cross-subsidization: financing Beijing's health-insurance reform," Health Policy, Elsevier, vol. 72(1), pages 41-52, April.
    13. Jia CUI & Shaomin HUANG & Gerald RAMEY, 2009. "China’s Healthcare Reform And Resources Redistribution: Lessons For Emerging Nations," Review of Economic and Business Studies, Alexandru Ioan Cuza University, Faculty of Economics and Business Administration, issue 4, pages 27-42, November.
    14. Wang, H. Holly & Rosenman, Robert, 2007. "Perceived need and actual demand for health insurance among rural Chinese residents," China Economic Review, Elsevier, vol. 18(4), pages 373-388.
    15. Jens Hougaard & Lars Østerdal & Yi Yu, 2011. "The Chinese healthcare system," Applied Health Economics and Health Policy, Springer, vol. 9(1), pages 1-13, January.
    16. Jens Leth Hougaard & Lars Peter Østerdal & Yi Yu, 2008. "The Chinese Health Care System: Structure, Problems and Challenges," Discussion Papers 08-01, University of Copenhagen. Department of Economics.

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