|
|
|
| Self-selection and Medical Expenditure in Chinese Health Insurance System: Evidence from Informal Employees' Participation |
| FENG Jin, WANG Zhen, SONG Hong
|
| School of Economics, Fudan University |
|
|
|
|
Abstract China's public health insurance has reached universal coverage. Current challenge is to keep the sustainability of health insurance system. According to the arrangement, informal employees can voluntarily participate in the Urban Employee Based Medical Insurance (UEBMI), which may raise the adverse selection issue. We take advantage of the institutional features of Chinese system, using the China Family Panel Studies (CFPS) 2012-2014 data, to distinguish adverse selection from moral hazard empirically and find that people who voluntarily participate in UEBMI have higher medical expenditure. The results show that people who voluntarily participate in UEBMI have about 78% more medical expenditure than those who compulsorily participate in UEBMI. Moreover, people who voluntarily participate in UEBMI have about 45% more medical expenses than those who participate in Residents Medical Insurance. The selectable medical insurance will improve the welfare of informal employees. However, it is necessary to reform the health insurance system to avoid the potential risk of deficit of health insurance system.
|
|
Received: 26 March 2018
Published: 01 November 2018
|
|
|
|
|
| [1] |
封进和宋铮,2007,《中国农村医疗保障制度:一项基于异质性个体决策行为的理论研究》,《经济学(季刊)》第3期,第841～858页。
|
| [2] |
黄枫和甘犁,2012,《医疗保险中的道德风险研究——基于微观数据的分析》,《金融研究》第5期,第193～206页。
|
| [3] |
李常印、郝春彭、李静湖和熊先军,2012,《基本医疗保险基金结余及动态平衡》,《中国医疗保险》第6期,第35～38页。
|
| [4] |
臧文斌、赵绍阳和刘国恩,2013,《城镇基本医疗保险中逆选择的检验》,《经济学(季刊)》第1期,第47～70页。
|
| [5] |
朱信凯和彭廷军,2009,《新型农村合作医疗中的“逆选择”问题:理论研究与实证分析》,《管理世界》第1期,第 79～88 页。
|
| [6] |
Arnott, Richard J., and Joseph E. Stiglitz. 1988. “The Basic Analytics of Moral Hazard,” The Scandinavian Journal of Economics, 90(3):383～413.
|
| [7] |
Cardon, James H., and Igal Hendel. 2001. “Asymmetric Information in Health Insurance: Evidence from the National Medical Expenditure Survey,” The Rand Journal of Economics, 32(3):408～427.
|
| [8] |
Carlin, Caroline, and Robert Town. 2009. “Adverse Selection, Welfare, and Optimal Pricing of Employer Sponsored Health Plans,” University of Minnesota Working Paper.
|
| [9] |
Chetty, Raj, and Amy Finkelstein. 2012. “Social Insurance: Connecting Theory to Data,” NBER Working Papers, 111～193.
|
| [10] |
Chiappori, Pierre Andre, and Bernard Salanié. 2000. “Testing for Asymmetric Information in Insurance Markets,” Journal of Political Economy, 108(1):56～78.
|
| [11] |
Cohen, Alma, and Peter Siegelman. 2010. “Testing for Adverse Selection in Insurance Markets,” Journal of Risk & Insurance, 77(1):39～84.
|
| [12] |
Culter, David M., and Richard J. Zeckhauser. 2000. “The Anatomy of Health Insurance,” Handbook of Health Economics, 1:563～643.
|
| [13] |
Culter, David M., and Sarah J. Reber. 1998. “Paying for Health Insurance: The Trade-Off between Competition and Adverse Selection,” Quarterly Journal of Economics, 113(2):433～466.
|
| [14] |
De Meza, David, and David C. Webb. 2001. “Advantageous Selection in Insurance Markets,” The RAND Journal of Economics, 32(2):249～262.
|
| [15] |
Duan, Naihua, Willard G. Manning, Carl N. Morris, and Joseph P. Newhouse. 1983. “A Comparison of Alternative Models for the Demand for Medical Care,” Journal of Business & Economic Statistics, 1(2):115～126.
|
| [16] |
Einav, Liran, Amy Finkelstein, and Mark R. Cullen. 2010. “Estimating Welfare in Insurance Markets Using Variation in Prices,” Quarterly Journal of Economics, 125(3):877～921.
|
| [17] |
Einav, Liran, Amy Finkelstein, Stephen P. Ryan, Paul Schrimpf, and Mark R. Cullen. 2013. "Selection On Moral Hazard in Health Insurance," American Economic Review, 103(1):178～219.
|
| [18] |
Ettner, Susan L. 1997. "Adverse Selection and the Purchase of Medigap Insurance by the Elderly," Journal of Health Economics, 16(5):543～562.
|
| [19] |
Fang, Hanming, Michael P. Keane, and Silverman Dan. 2008. “Sources of Advantageous Selection: Evidence from the Medigap Insurance Market,” Journal of Political Economy, 116(2):303～350.
|
| [20] |
Finkelstein, Amy, and James Poterba. 2004. “Adverse Selection in Insurance Markets: Policyholder Evidence from the U.K. Annuity Market,” Journal of Political Economy, 112(1):183～208.
|
| [21] |
Finkelstein, Amy, and Kathleen McGarry. 2006. “Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market,” American Economic Review, 96(4):938～958.
|
| [22] |
Glied, Sherry. 2000. “Managed Care,” Handbook of Health Economics, 1:707～753.
|
| [23] |
Handel, Benjamin R. 2013. “Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts,” American Economic Review, 103(7):2643～2682.
|
| [24] |
Hemenway, David. 1990. "Propitious Selection," Quarterly Journal of Economics, 105(4):1063～1069.
|
| [25] |
Jones, Andrew M. 2000. “Health Econometrics,” Handbook of Health Economics, 1:265～346.
|
| [26] |
Rothschild, Michael, and Joseph Stiglitz. 1976. “Equilibrium in Competitive Insurance Markets: An Essay On the Economics of Imperfect Information,” Quarterly Journal of Economics, 90(4):257～280.
|
| [27] |
Wang, Hong, Licheng Zhang, Winnie Yip, and William Hsiao. 2006. “Adverse Selection in a Voluntary Rural Mutual Health Care Health Insurance Scheme in China,” Social Science & Medicine, 63(5):1236～1245.
|
| [28] |
Wilson, Charles. 1977. “A Model of Insurance Markets with Incomplete Information,” Journal of Economic Theory, 16(2):167～207.
|
| [29] |
Xie, Yu, Jingwei Hu, and Chunni Zhang. 2014. “The China Family Panel Studies: Design and Practice,” Chinese Journal of Sociology, 34(2):1～32.
|
| [30] |
Zhang, Licheng, and Hong Wang. 2008. “Dynamic Process of Adverse Selection: Evidence from a Subsidized Community-Based Health Insurance in Rural China,” Social Science & Medicine, 67(7):1173～1182.
|
| No related articles found! |
|
|
|
|
