The Chinese government has launched a series of health reforms to establish universal health insurance coverage, particularly for vulnerable groups, including middle-aged and older adults. However, the current public health insurance system is highly fragmented, consisting of different programs with different levels of premiums and benefits. We analyse whether the universal health insurance system increases the life satisfaction of middle-aged and older Chinese people and to what extent the type of health insurance affects the life satisfaction of this group.
Our study is based on data from the China Health and Retirement Longitudinal Study, a nationally representative longitudinal survey of Chinese aged 45 and above, in 2011, 2013, and 2015. We find that the life satisfaction of middle-aged and older adults does not depend on having any health insurance coverage but varies with the type of health insurance coverage, controlling for potential confounding variables such as health status, occupation, hukou status, and other demographic variables. Individuals covered by the most generous program, the Government Medical Insurance, reported a higher life satisfaction. In comparison, individuals covered by the Urban Employee Medical Insurance, the Urban Resident Medical Insurance, and the New Rural Cooperative Scheme reported a lower life satisfaction by 0.155, 0.106, and 0.112 standard deviations, respectively.
Our results suggest that establishing a more equitable health insurance system should be the next step in health reforms in China.
Sisi Yang was a Senior Research Associate with CEPAR (the ARC Centre of Excellence in Population Ageing Research), located at the UNSW Business School, from 2018 to 2020. Currently, she is a Associate Investigator of CEPAR and Research Assistant at the UNSW Institute for Global Development. She received her PhD in Demography/Sociology at the Chinese Academy of Social Sciences (CASS) in 2016, and received her second PhDs (cotutelle) in Demography/Sociology from Macquarie University in 2018. Sisi’s research interests focus on well-being and social equality in the context of migration and urbanization, with a focus on inequality in health, labour market and migrant workers, and ageing and well-being, mainly based on data from large scale surveys, censuses and interview data.