Abstract
Studying the factors that influence commercial health insurance consumption is essential in insurance economics. Family ties are important factors that affect consumer behaviour, especially in Eastern countries such as China. We construct an index to measure family ties and examine their effect on commercial health insurance consumption. We also use an instrumental variable approach to address endogeneity and apply a complementary log–log regression to deal with rare-event bias. We find that family ties have significantly positive impacts on individuals’ and families’ commercial health insurance consumption. The effect of family ties on commercial health insurance consumption is greater in individuals/families with higher income levels, those in eastern provinces, and those who are older.
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Notes
For instance, in 2018, national health expenditure in China was CNY 5.91 trillion, accounting for 6.43% of GDP. This share has been increasing in recent years. Moreover, China’s out-of-pocket health payments in 2018 were CNY 1.69 trillion, accounting for 28.61% of total health expenditures, whereas this rate was less than 15% in 2015 in the U.K., U.S., Germany and other countries.
According to the China Medical and Health Development Report 2018, the medical insurance fund for urban workers faces the risk of running a negative balance in China. In 2017, China's overall health expenditure reached CNY 5.15 trillion, with a growth rate of 11.34%—much higher than the GDP growth rate of 6.9% in the same period. The maintenance of such growth rates would imply great financial burdens in the future.
The data are available at https://chfs.swufe.edu.cn/.
For 2013, the survey data cover 29 provinces (or municipalities directly under the central government and the autonomous regions), 262 counties and 1048 village (residential) committees, offering a valid sample of 28,000 families. For 2015, the data cover 29 provinces, 363 counties and 1439 village (residential) committees and offer 40,000 valid observations.
For robustness, we also report the results with observations with an age above 65 or an average income of 0 in Table 6 in the Appendix. Overall, the results are robust.
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Funding was provided by National Natural Science Foundation of China (Grant No. 71974221.)
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Chen, H., Ding, Y., Li, R. et al. Family ties and commercial health insurance consumption in China. Geneva Pap Risk Insur Issues Pract 48, 247–265 (2023). https://doi.org/10.1057/s41288-021-00242-6
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DOI: https://doi.org/10.1057/s41288-021-00242-6