Abstract:

Based on the data of the “China Health and Retirement Longitudinal Study” (CHARLS) collected in the four waves of surveys during 2011-2018, this paper investigates the impact of the urban-rural identity, region and income-level on the basic medical insurance benefits and equity of such benefits for the two types of basic medical insurance participants. The study finds that the coverage of the medical insurance for urban employees is rather low, while the actual coverage of the medical insurance for urban and rural residents is higher than the coverage aimed by the scheme; the benefit level of the insured in urban, eastern regions, or with high-income tends to be higher; the out-of-pocket medical expenses form a heavier burden on low-income patients. Nevertheless, the participants’ benefits level and equity in different dimensions has been improved with time. The results of empirical analysis show that within the medical insurance for urban employees, there is a significant regional gap, as the hospitalization expenses decreasing in the order of eastern, central, western, and northeastern regions. The health level of participants in the western region is significantly lower than that in the eastern region. Within the medical insurance for urban and rural residents, the urban participants tend to receive significantly higher benefits than rural participants and urban migrants; the health level of residents in the eastern region is the highest, while that of residents in the western region is the lowest; the participants with lower income tend to have lower hospitalization expenses and poorer health. These findings have some policy implications for further narrowing the benefit gap among the insured with different characteristics of urban-rural identity, region, and income level to promote social equity and common prosperity.

Key words: basic medical insurance, benefit equity, urban-rural gap, regional disparities, income gap, common prosperity