Chinese Journal of Sociology ›› 2019, Vol. 39 ›› Issue (2): 58-84.

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Does “Basic Health Protection for All” Improve Farmers'Health? Reassessing the Effect of CNCMS on Medical Service Utilization, Health and Income of Inpatients

ZHANG Dan1, XU Zhigang1, CHEN Pin2   

  1. 1. College of Economics and Management, Nanjing Agricultural University;
    2. School of Economics and Management, Changzhou Institute of Technology
  • Online:2019-03-20 Published:2019-03-20

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Abstract:

China's New Cooperative Medical Scheme (CNCMS) has basically achieved “Basic Health Protection for All”, but there is still no consensus whether the program has really improved the farmers' health. There are two main reasons: one is that the effect of CNCMS maybe is limited because of the principle of “wide coverage and low copayment” followed before the New Medical Reform in 2009, but its effect has strengthened after that and the data previous research used is before 2009 mostly, therefore it cannot estimate the effect brought by the New Medical Reform accurately; the other reason is that the previous research ignores the heterogeneity of people with different age, health and wealth. Based on the data of 2011 and 2013 CHARLS(China Health and Retirement Longitudinal Study) national survey, this study explores the effect of CNCMS on farmers' medical expenditure, health status and income systematically by using propensity score matching (PSM). We mainly focus on people who have higher demand for medical care such as inpatients or people who should have been, and all samples are divided into different groups by age, health and wealth. The result shows that, although CNCMS has an effect on farmers' health status, it is limited and hard to say CNCMS can fully improve farmers' health, even for those who have poorer health, demanding more medical care or are referred to hospital. However, those who are older, poorer or have poorer health have huge benefit. For them, CNCMS has a positive and strong effect and it can improve their health significantly without increasing out-of-pocket expenditure. Besides, the longer time they enroll in it the greater the effect. For those who are younger and have better health, participating in CNCMS will let them have more access to medical service.

Key words: CNCMS, PSM, health status, medical expenditure, income