Inequality in social health insurance programmes in China: A theoretical approach

Abstract

Equity is one of the goals of China’s new round of health care reform. Results from existing empirical studies provide evidence for the existence of highly unequal distribution of insurance benefits under China’s current social health insurance programmes. This paper aims to explain inequity in health insurance by connecting the ways through which insurance programmes are financed with benefit distribution. A theoretical approach is employed, and we find that the inconsistency between insurance premiums and expected benefits among different income levels is the main source of inequity in social health insurance programmes. Our results suggest that the design of premium and reimbursement schemes should be aligned with the income level of the insurant.

Keywords:

• inequity
• health insurance
• net benefit
• health care reform
• China

Notes

1. The nine cities are Jilin, Zibo, Baotou, Xining, Changde, Chendu, Shaoxing, Xiamen and Urumuqi.

Additional information

Funding

We are grateful to the National Natural Science Foundation of China [71303165 and 71303175], the China Postdoctoral Science Foundation [2013M540706, 2014T70863 and 2014M560830], Sichuan University [skqx201401] and China Medical Board [13–167] for their financial support. The authors are responsible for all remaining errors.