Health Insurance, Rural-to-urban Migration, and Social Inequality in China Fang-I Wen (Co-authored with Hung-Hao Chang) Chung-Hua Institution for Economic Research 10 July 2008

Background  Hukou system  agricultural and non-agricultural hukou  The economic reform and the relaxation of migration policy  The social inequality for migrant workers

Background  Health Insurance Coverage in China (Previous Studies)  Single equation model  Regional disparity → urban versus rural areas  Socioeconomic status → occupation, income, gender (Henderson et al, 1995; Akin, Dow, & lance, 2004)

Empirical Study of Health Coverage in Urban China  Objective: → Examine the association between Hukou system, working status, and the accessibility to health insurance in urban China  Model: Bivariate Probit Model  Data: → micro-level data drawn from the China Health and Nutrition Survey (CHNS) in 2006 → focus on the data from city sites, and respondents who are currently working with age between 18 and 65.

Empirical Study of Health Coverage in Urban China  Bivariate Probit Model

Empirical Study of Health Coverage in Urban China  I 1 represents working status  I 1 = 1 if the individual’s primary job is a part-time job  I 2 represents health insurance status  Model 1: I 2 = 1 if the individual has any types of health insurance  Model 2: I 2 = 1 if the individual has employment-related health insurance  X represents socioeconomic and regional variables  age, gender, education, wealth index, provinces

Empirical Study of Health Coverage in Urban China  Marginal Effect on prob (part-time = 1)

Empirical Study of Health Coverage in Urban China  Marginal Effect on prob (part-time = 1) (continued)

Empirical Study of Health Coverage in Urban China  Marginal Effect on prob (insurance=1)

Empirical Study of Health Coverage in Urban China  Marginal Effect on prob (insurance=1) (continued)

Empirical Study of Health Coverage in Urban China  Types of health insurance types – by provinces

Empirical Study of Health Coverage in Urban China  Statistical Tests

Concluding comments  The individuals with “rural hukou” are at a disadvantage at their job seeking. → They are more likely be hired as a part-time employee than their “urban hukou” counterpart.  The disadvantage of the migrant workers in the labor market will lead to the inequality in their entitled health benefits.

Concluding comments  The migrant workers’ working benefits may not be easy to get improved in the short-run. → Increase migrant workers’ health insurance coverage by improving the cooperative insurance system might be a more practical way.