Evaluating the Impact of China's Rural Insurance Scheme on Health Using Biomarkers

Katherine Donato, Harvard University
Slawa Rokicki, Harvard University

On September 6, 2013 the Chinese government announced that its New Cooperative Medical Scheme (NCMS), a health insurance program begun in 2003 for rural residents, covered 99 percent of rural residents – 800 million people. A decade prior only 8 million rural residents had access to any health insurance. Despite this rapid scale up, evidence of the program’s effectiveness at improving health remains limited. In this paper, we evaluate the effect of NCMS coverage on objective health measures, including blood pressure and biomarkers. We reduce selection bias using an ITT and instrumental variable strategy. We find no indication of improved health for those with access to NCMS, measured by blood pressure, biomarkers including total cholesterol, HbA1c, LDL, HDL, triglycerides, or the Framingham Risk Score. We do, however, consistently find an increase in utilization of preventive health services for those with access to NCMS.