Urban Health Insurance Reform: What Can We Learn from the Pilot Experiments?

This paper assesses China’s decade-long efforts in reforming its urban health insurance programs. Both the literature and aggregate data suggest that the new community-based insurance program appears to be efficient in short-run cost saving, due in large part to some demand-side cost sharing measures, including co-payment, deductibles, and medical savings account. In the long run, however, it remains unclear whether the total cost containment can sustain without concurrent reforms in supply-side cost sharing mechanisms. Moreover, 39 the study finds previous research and policy efforts to focus overwhelmingly on cost containment, giving little attention to health outcomes measurement. Future research is warranted to evaluate changes in health outcomes associated with the reform.