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How Does the Basic Urban-Rural Medical Insurance Affect Resident Health Inequality? Evidence from China
Xiaohong Pu1, Riyun Hou1, Sichang He2
1School of Public Administration, Sichuan University, Chengdu 610065, China.
Background:
Health inequality is seen as a challenge for implementing the Healthy China Strategy. This study analyzes the income-related health inequality among urban-rural resident basic medical insurance (URRBMI) participants.
Methods:
This study utilized data from the 2019 China Household Finance Survey (CHFS), and the concentration index (CI) was employed to estimate the effects of income-related health inequality on participants.
Results:
Our findings provide clear evidence that health inequality among participants has fluctuated-narrowing, widening, and then narrowing again-in the areas of the contribution, medical treatment, and reimbursement of URRBMI, respectively. Overall, the analysis indicates a widening of health inequality post-reimbursement, with results remaining consistent. A heterogeneity analysis shows that health inequality is most pronounced among women and those with less than a middle school education. Finally, our study reveals a pro-rich trend in the actual utilization of medical services among participants, with persistent disparities in outpatient and inpatient service usage even after standardization, further exacerbating income-related health inequality.
Conclusions:
We recommend that the URRBMI design take participants' income levels into account, with policies favoring disadvantaged individuals to enhance their medical security, improve access to healthcare services, and ultimately reduce health inequality.
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