NTA and China’ China’s Public Policy
Ling Li Qiulin Chen Yu Jiang 2010-6-11 Honolulu
China: the Era of Great Change 1949-1978
1978-2008
– Planed economy
– Market economy
– Low economic growth, high savings
– High economic growth
– High fertility and low mortality rates
– Low fertility and low mortality rates
– National based social security system
– Marketlized social security system
Backgroud of the evulution • The transition of social development – – – – –
2003“Scientific development” and "homonious society “ Emphasize justice and equality More government expenditure to the public service Reconstruct the social security system
Issue 1: Public vs Private
The evolution of China's healthcare system • In 1999, China began to reform its healthcare system
Before reform – Urban: Comprehensive Social Security for the employees (and their relatives) – Rural: Cooperated Medical Service
After reform – Urban: • Employee's health insurance(1998-) • Citizen’s social insurance(2007-) – Rural • New Cooperated Medical Insurance(2003-)
NTA and Health Age Profile of Health Consumption,1995 900 800 700 600 500 400 300 200 100 0 1
5
9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89 Health,urban
Health,rural
Health,National
The Change of J Curve China's J Curve,1998, Smoothed 500 450 400
National
Male
Female
350 RMB
300 250 200 150 100 50 0 0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 75 78 81 84 87 90 Age
The Change of J Curve China's J Curve,2003, smoothed 2500 National
Urban
Rural
2000
RMB
1500
1000
500
0 0 3
6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 75 78 81 84 87 90
Age
Public Private
Health: public and private 800
90
700
80
600
70 60
500
50
400
40
300
30
200
20
100
10
0
0 1
6 11 16 21 26 31 36 41 46 51 56 61 66 71 76 81 86 91
1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89
China urban 1995 $20,000
China rural 1995 18000 16000 14000 12000 10000 8000 6000 4000 2000 0
$18,000 $16,000 $14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $2,000 $0 1
7 13 19 25 31 37 43 49 55 61 67 73 79 85 91
The USA 2000
1
7 13 19 25 31 37 43 49 55 61 67 73 79 85 91
Thailand 2004
Comparison
Comparison, China 1995 and 2002,per capita
0.010 0.008 Public Health 1995y Public Health 2002y
0.006 Ratio
0.004 0.002
Age (Normalized by average Labor Income of age 30-49)
88
80
72
64
56
48
40
32
24
16
8
0
0.000
Comparison
Comparison, China 1995 and 2002,per capita
0.050 0.040 Private Health 1995y Private Health 2002y
0.030 Ratio
0.020 0.010
0 8 16 24 32 40 48 56 64 72 80 88
0.000 Age
(Normalized by average Labor Income of age 30-49)
Comparison
Comparison, China 1995 and 2002,per capita
0.050 0.040 0.030 Ratio
0.020 0.010
-0.020
Age (Normalized by average Labor Income of age 30-49)
90
81
72
63
54
45
36
27
18
9
-0.010
0
0.000
Health 1995 Health 2002 Health 1995 Health 2002
Inflow Inflow Outflow Outflow
Consumption between health and education Public Consumption,China,pe r capita,2002
Public Consumption,Other
1600
Public Consumption,He alth Public Consumption,Education
1400 1200
800
Yuan
1000
Yuan
Public Consumption,China,pe r capita,1995
800
600
600
400
400
200
200
0
0
0
7 14 21 28 35 42 49 56 63 70 77 84 Age
0
8
16
24 32 40 48 Age
56 64 72 80 88
Public Education, Comparison
China 1995 & 2002, per capita
Ratio Age (Normalized by average Labor Income of age 30-49)
Private Education, Comparison
China 1995 & 2002, per capita 0.12 0.10 0.08 0.06
Ratio
0.04 0.02
Private Education 1995y
Private Education 2002y
Age (Normalized by average Labor Income of age 30-49)
88
84
80
76
72
68
64
60
56
52
48
44
40
36
32
28
24
20
16
12
8
4
0
0.00
Private Education, Comparison between urban and rural Education, Rural and Urban,China,percapita,2002
3000 2500
Yuan
2000 1500 1000 500 0 -500 0
6
12 18 24 30 36 42 48 54 60 66 72 78 84 90+ Age
Urban Education,unsmoothed
Urban Education,smoothed
Rural Education,unsmoothed
Rural Education, smoothed
Intra HH Transfer: Education –Comparison
China 1995 and 2002,per capita 0.20 0.15 0.10
-0.05 -0.10
Education Inflow 1995 Education Outflow 1995
Age
Education Inflow 2002 Education Outflow 2002
88
84
80
76
72
68
64
60
56
52
48
44
40
36
32
28
24
20
16
12
8
4
0.00
0
Ratio
0.05
Intra HH Transfer: Health – Comparison
China 1995 and 2002,per capita 0.05 0.04 0.03 0.02
-0.02
Health Inflow 1995 Health Outflow 1995
Age
Health Inflow 2002 Health Outflow 2002
90 +
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
-0.01
5
0.00 0
Ratio
0.01
Public TransferTransfer- Comparison
Public transfer,net 1995y
Age
88
84
80
76
72
68
64
60
56
52
48
44
40
36
32
28
24
20
16
12
8
4
Ratio
0.25 0.20 0.15 0.10 0.05 0.00 -0.05 -0.10 -0.15 -0.20
0
China 1995 and 2002, per capita
Public transfer,net 2002y
The future of China’s healthcare?
• Hot debate—— • “Subsidy the demand side or the supply side” •
“Social Insurance System or National Healthcare Service (NHS) system”
The future of China’s healthcare? • The new healthcare system increase rather than control the cost 2500
2000
1500
1000
500
0 0-4岁
5-14岁
15-24岁
25-34岁
35-44岁
45-54岁
55-64岁
65岁及以 上
N o In su ra n c e
U rb a n Em p lo ye e 's H e a lth In su ra n c e
G o ve rn e m t e m p lo ye e 's H e a lth In su ra n c e
C o m p re h e n sive so c ia lIn su ra n c e
C o o p e ra te d M e d ic a lSe rvic e
O th e r
Priva te In su ra n c e
Issue 2: Gender
Background • Women liberation along with the revolution during the 20th century • Unequally competition in a export-oriented and labor-intensive economy • 200 million migrated from the rural to urban for work • Weaken of social security system • Oversupply of cheap labor: Labor super market
Labor Income Preliminary result
• Labor Income Urban, 2002, per capita
Labor Income Preliminary result
• Labor Income Rural, 2002, per capita
consumption Preliminary result
• Private consumption urban, 2002, per capita
consumption Preliminary result
• Private consumption urban, 2002, per capita
consumption Preliminary result
• Private consumption rural , 2002, per capita
consumption Preliminary result
• Private consumption rural , 2002, per capita
Next step • Transfers between genders • Estimate the transfer between the urban and rural by the immigration
• Thanks