Is Chinese National Health Insurance Effective in the Face of Severe Illness? A Perspective from Health Service Utilization and Economic Burden

Over the past decade, health insurance coverage has expanded dramatically in China. Health insurance benefits, however, remain shallow or ambiguous. This study examines the effect of Chinese national health insurance policy on health service utilization and economic burden in urban settings using the Urban Resident Basic Medical Insurance Household Survey. We employ the Heckman selection model to correct for selection bias among hospital inpatients, and find that compared to individuals without health insurance, those with health insurance are more likely to be admitted to the hospital when their physicians recommended them to enter the hospital as inpatients. Health insurance is also associated with about 45.6 % decrease in out-of-pocket inpatient expenditures. Individuals with urban employee basic medical insurance see the largest decrease in economic burden, followed by individuals with urban resident basic medical Insurance, and those with new rural cooperative medical insurance.