SS10 S2b China

NTA and China’ China’s Public Policy Ling Li Qiulin Chen Yu Jiang 2010-6-11 Honolulu China: the Era of Great Change 1...

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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