Health Shocks in China : Are the Poor and Uninsured Less Protected?

Health shocks have been shown to have important economic consequences in industrial countries. Less is known about how health shocks affect income, consumption, labor market outcomes, and medical expenditures in middle- and low-income countries. The authors explore these issues in China. In addition...

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Main Authors:	Lindelow, Magnus, Wagstaff, Adam
Format:	Policy Research Working Paper
Language:	English
Published:	World Bank, Washington, DC 2012
Subjects:	ACTIVITY LIMITATIONS AGRICULTURAL PRICES CONSUMPTION INSURANCE CONSUMPTION SMOOTHING COST OF CARE DEMAND FOR HEALTH ECONOMIC DEVELOPMENT ECONOMIC OUTCOMES ECONOMIC PERSPECTIVES ECONOMIC REVIEW FARMERS FEE-FOR-SERVICE FEE-FOR-SERVICE PAYMENT FINANCIAL INCENTIVES FOOD CONSUMPTION FOOD SAFETY GENDER HEALTH CARE HEALTH EXPENDITURES HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEME HEALTH INSURANCE SYSTEM HEALTH POLICY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOUSEHOLD HEAD HOUSEHOLD HEADS HOUSEHOLD INCOME HOUSEHOLD SIZE HOUSEHOLD VULNERABILITY HOUSEHOLDS IDIOSYNCRATIC SHOCKS INCOME INCOME RISK INCOME SMOOTHING INCOME VARIABLE LOW-INCOME COUNTRIES MEDICAL CARE MEDICAL EXPENDITURE MEDICAL EXPENDITURES MEDICAL INSURANCE MORBIDITY MORTALITY NEIGHBOURHOODS NEW COMMUNITIES NUTRITION POCKET PAYMENTS POLICY RESEARCH POLITICAL ECONOMY POOR POVERTY POVERTY STATUS PUBLIC INSURANCE QUALITY CONTROL RENTALS RISK MANAGEMENT RISK SHARING RURAL RURAL AREA RURAL AREAS RURAL HEALTH SAFETY NETS SAVINGS URBAN AREAS VILLAGES WELFARE FUNDS WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2005/10/6323619/health-shocks-china-poor-uninsured-less-protected http://hdl.handle.net/10986/8499

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recordtype	oai_dc
spelling	okr-10986-84992021-04-23T14:02:43Z Health Shocks in China : Are the Poor and Uninsured Less Protected? Lindelow, Magnus Wagstaff, Adam ACTIVITY LIMITATIONS AGRICULTURAL PRICES CONSUMPTION INSURANCE CONSUMPTION SMOOTHING COST OF CARE DEMAND FOR HEALTH ECONOMIC DEVELOPMENT ECONOMIC OUTCOMES ECONOMIC PERSPECTIVES ECONOMIC REVIEW FARMERS FEE-FOR-SERVICE FEE-FOR-SERVICE PAYMENT FINANCIAL INCENTIVES FOOD CONSUMPTION FOOD SAFETY GENDER HEALTH CARE HEALTH EXPENDITURES HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEME HEALTH INSURANCE SYSTEM HEALTH POLICY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOUSEHOLD HEAD HOUSEHOLD HEADS HOUSEHOLD INCOME HOUSEHOLD SIZE HOUSEHOLD VULNERABILITY HOUSEHOLDS IDIOSYNCRATIC SHOCKS INCOME INCOME RISK INCOME SMOOTHING INCOME VARIABLE LOW-INCOME COUNTRIES MEDICAL CARE MEDICAL EXPENDITURE MEDICAL EXPENDITURES MEDICAL INSURANCE MORBIDITY MORTALITY NEIGHBOURHOODS NEW COMMUNITIES NUTRITION POCKET PAYMENTS POLICY RESEARCH POLITICAL ECONOMY POOR POVERTY POVERTY STATUS PUBLIC INSURANCE QUALITY CONTROL RENTALS RISK MANAGEMENT RISK SHARING RURAL RURAL AREA RURAL AREAS RURAL HEALTH SAFETY NETS SAVINGS URBAN AREAS VILLAGES WELFARE FUNDS WORKERS Health shocks have been shown to have important economic consequences in industrial countries. Less is known about how health shocks affect income, consumption, labor market outcomes, and medical expenditures in middle- and low-income countries. The authors explore these issues in China. In addition to providing new evidence on the general impact of health shocks, they also extend previous work by assessing the extent of risk protection afforded by formal health insurance, and by examining differences in the impact of health shocks between the rich and poor. The authors find that health shocks are associated with a substantial and significant reduction in income and labor supply. There are indications that the impact on income is less important for the insured, possibly because health insurance coverage is also associated with limited sickness insurance, but the effect is not significant. They also find evidence that negative health shocks are associated with an increase in unearned income for the poor but not the non-poor. This effect is however not strong enough to offset the impact on overall income. The loss in income is a consequence of a reduction in labor supply for the head of household, and the authors do not find evidence that other household members compensate by increasing their labor supply. Finally, negative health shocks are associated with a significant increase in out-of-pocket health care expenditures. More surprisingly, there is some evidence that the increase is greater for the insured than the uninsured. The findings suggest that households are exposed to considerable health-related shocks to disposable income, both through loss of income and health expenditures, and that health insurance offers very limited protection. 2012-06-19T22:02:37Z 2012-06-19T22:02:37Z 2005-10 http://documents.worldbank.org/curated/en/2005/10/6323619/health-shocks-china-poor-uninsured-less-protected http://hdl.handle.net/10986/8499 English Policy Research Working Paper; No. 3740 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research East Asia and Pacific China
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English
topic	ACTIVITY LIMITATIONS AGRICULTURAL PRICES CONSUMPTION INSURANCE CONSUMPTION SMOOTHING COST OF CARE DEMAND FOR HEALTH ECONOMIC DEVELOPMENT ECONOMIC OUTCOMES ECONOMIC PERSPECTIVES ECONOMIC REVIEW FARMERS FEE-FOR-SERVICE FEE-FOR-SERVICE PAYMENT FINANCIAL INCENTIVES FOOD CONSUMPTION FOOD SAFETY GENDER HEALTH CARE HEALTH EXPENDITURES HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEME HEALTH INSURANCE SYSTEM HEALTH POLICY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOUSEHOLD HEAD HOUSEHOLD HEADS HOUSEHOLD INCOME HOUSEHOLD SIZE HOUSEHOLD VULNERABILITY HOUSEHOLDS IDIOSYNCRATIC SHOCKS INCOME INCOME RISK INCOME SMOOTHING INCOME VARIABLE LOW-INCOME COUNTRIES MEDICAL CARE MEDICAL EXPENDITURE MEDICAL EXPENDITURES MEDICAL INSURANCE MORBIDITY MORTALITY NEIGHBOURHOODS NEW COMMUNITIES NUTRITION POCKET PAYMENTS POLICY RESEARCH POLITICAL ECONOMY POOR POVERTY POVERTY STATUS PUBLIC INSURANCE QUALITY CONTROL RENTALS RISK MANAGEMENT RISK SHARING RURAL RURAL AREA RURAL AREAS RURAL HEALTH SAFETY NETS SAVINGS URBAN AREAS VILLAGES WELFARE FUNDS WORKERS
spellingShingle	ACTIVITY LIMITATIONS AGRICULTURAL PRICES CONSUMPTION INSURANCE CONSUMPTION SMOOTHING COST OF CARE DEMAND FOR HEALTH ECONOMIC DEVELOPMENT ECONOMIC OUTCOMES ECONOMIC PERSPECTIVES ECONOMIC REVIEW FARMERS FEE-FOR-SERVICE FEE-FOR-SERVICE PAYMENT FINANCIAL INCENTIVES FOOD CONSUMPTION FOOD SAFETY GENDER HEALTH CARE HEALTH EXPENDITURES HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEME HEALTH INSURANCE SYSTEM HEALTH POLICY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOUSEHOLD HEAD HOUSEHOLD HEADS HOUSEHOLD INCOME HOUSEHOLD SIZE HOUSEHOLD VULNERABILITY HOUSEHOLDS IDIOSYNCRATIC SHOCKS INCOME INCOME RISK INCOME SMOOTHING INCOME VARIABLE LOW-INCOME COUNTRIES MEDICAL CARE MEDICAL EXPENDITURE MEDICAL EXPENDITURES MEDICAL INSURANCE MORBIDITY MORTALITY NEIGHBOURHOODS NEW COMMUNITIES NUTRITION POCKET PAYMENTS POLICY RESEARCH POLITICAL ECONOMY POOR POVERTY POVERTY STATUS PUBLIC INSURANCE QUALITY CONTROL RENTALS RISK MANAGEMENT RISK SHARING RURAL RURAL AREA RURAL AREAS RURAL HEALTH SAFETY NETS SAVINGS URBAN AREAS VILLAGES WELFARE FUNDS WORKERS Lindelow, Magnus Wagstaff, Adam Health Shocks in China : Are the Poor and Uninsured Less Protected?
geographic_facet	East Asia and Pacific China
relation	Policy Research Working Paper; No. 3740
description	Health shocks have been shown to have important economic consequences in industrial countries. Less is known about how health shocks affect income, consumption, labor market outcomes, and medical expenditures in middle- and low-income countries. The authors explore these issues in China. In addition to providing new evidence on the general impact of health shocks, they also extend previous work by assessing the extent of risk protection afforded by formal health insurance, and by examining differences in the impact of health shocks between the rich and poor. The authors find that health shocks are associated with a substantial and significant reduction in income and labor supply. There are indications that the impact on income is less important for the insured, possibly because health insurance coverage is also associated with limited sickness insurance, but the effect is not significant. They also find evidence that negative health shocks are associated with an increase in unearned income for the poor but not the non-poor. This effect is however not strong enough to offset the impact on overall income. The loss in income is a consequence of a reduction in labor supply for the head of household, and the authors do not find evidence that other household members compensate by increasing their labor supply. Finally, negative health shocks are associated with a significant increase in out-of-pocket health care expenditures. More surprisingly, there is some evidence that the increase is greater for the insured than the uninsured. The findings suggest that households are exposed to considerable health-related shocks to disposable income, both through loss of income and health expenditures, and that health insurance offers very limited protection.
format	Publications & Research :: Policy Research Working Paper
author	Lindelow, Magnus Wagstaff, Adam
author_facet	Lindelow, Magnus Wagstaff, Adam
author_sort	Lindelow, Magnus
title	Health Shocks in China : Are the Poor and Uninsured Less Protected?
title_short	Health Shocks in China : Are the Poor and Uninsured Less Protected?
title_full	Health Shocks in China : Are the Poor and Uninsured Less Protected?
title_fullStr	Health Shocks in China : Are the Poor and Uninsured Less Protected?
title_full_unstemmed	Health Shocks in China : Are the Poor and Uninsured Less Protected?
title_sort	health shocks in china : are the poor and uninsured less protected?
publisher	World Bank, Washington, DC
publishDate	2012
url	http://documents.worldbank.org/curated/en/2005/10/6323619/health-shocks-china-poor-uninsured-less-protected http://hdl.handle.net/10986/8499
_version_	1764407876202266624

Health Shocks in China : Are the Poor and Uninsured Less Protected?

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