Benefit Distribution Of Social Health Insurance In Rural China

This thesis examines the benefit distribution of social health insurance in China,a rapidly developing country with substantial economic growth and significant socio-economic policy reforms.The rapid and tremendous development of the healthcare and social-economic reforms in China presents an opportunity to examine numerous multifaceted social health insurance policy issues to unveil how these policy reforms benefit rural based beneficiaries whose social economic characteristics are quite diverse.To enhance health service access and mitigate patients' financial burden,for rural residents,China has established the New Rural Cooperative Medical Scheme.However,since the insured high income and healthy have more opportunity to access health care,more benefits might be flowing to them rather than to the lower income and unhealthy.We analysed the benefit distribution of health insurance scheme for rural based beneficiaries with diverse income levels and varying health conditions to examine who is more likely to benefit from health insurance scheme which is primarily designed for rural residents in China.Using data drawn from China Health and Retirement Longitudinal Study(CHARLS)fielded between 2011 and 2013.Benefit,access to inpatient care or not and the out of pocket expenses,were examined.We examined the likelihood of accessing inpatient care among rural resident NRCMS beneficiaries using a Logit model,and degree of Out of pocket expenses incurred using OLS model and found that,overall,it indicates that New Rural Cooperative Medical Scheme,indeed has enhanced rural people's access to healthcare,but on the other hand,it also indicates that this health policy does not benefit everyone in the same way.For instance,income level has a strong,positive,and highly statistically significant effect on access to inpatient care,but no statistically significant effect on Out of pocket(OOP)expenses.Our results show that beneficiaries from the higher income groups and relatively healthy,were more likely to benefit from the New rural cooperative medical scheme.This study provides new evidence on China's social health insurance reforms and it reveals significant policy implication for China and other developing countries which have embarked on universal coverage through social health insurance to take into account of beneficiaries,unique characteristics when designing and implementing broader social health policies.