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The Chinese urban–rural binary health insurance structure has contributed to a significant urban–rural segmentation and regional fragmentation, which will affect labor mobilization and urbanization. The purpose of this research is to study whether and how urban–rural binary health insurance impacts the intentions of migrant workers to switch between rural and urban hukou. Pooled data were drawn from China Migrants Dynamic Survey, collected by the National Health Commission of China. The study applied the instrument variable model due to the existence of the endogeneity; and the IVprobit model to conduct the empirical analysis. Our findings are as follows: (1) the urban–rural binary health insurance affects migrant workers’ intentions to switch to urban hukou significantly. (2) The negative impact of originally rural health insurance on migrant workers’ intention of switching to urban hukou is relatively large for low-education-level migrant workers. (3) Compared with new generation of migrant workers, old migrant workers have higher health insurance dependency levels. Finally, our research suggested several policy implications, such as accelerating the establishment of a unified urban–rural health insurance system, increasing the urban health insurance participation rate of migrant workers in their working cities, and including migrant workers in the scope of equal access to urban public services, etc. All the policy suggestions are essential in order to accelerate the citizenization of migrant workers, improve the quality of urbanization, and promote the construction of a unified national labor market.
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This study analyzes nationwide micro-survey data from the Chinese Longitudinal Healthy Longevity Survey 2018 to assess the impact of home care and medical insurance on the health of older people in China, using factors that influence healthcare utilization. Applying the Andersen model, the findings reveal: (1) Home care and medical service use are complementary, increasing inpatient service utilization and total medical costs. (2) The effect varies by insurance type. Under the New Rural Cooperative Medical Scheme, home care raises inpatient service use and costs. Under Urban Employee/Resident Medical Insurance, home care has no statistically significant impact. Under Public Medical Care for Civil Servants, home care reduces inpatient service use, suggesting substitution. (3) Age-related patterns differ across programs, with the New Rural Cooperative Medical Scheme showing declining utilization, the Urban Employee/Resident Medical Insurance exhibiting a diminishing increase, and the Public Medical Care for Civil Servants indicating potential overuse. The Chinese government should consider restructuring its national medical insurance programs and promoting the substitutive effect of home care to enhance the well-being and social security of the aging population. © International Atlantic Economic Society 2025.
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- Journal Article (2)
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- English (2)