Keywords
rural
middle-aged and elderly people
labor supply
labor migration
How to Cite
Abstract
Studying the influence of expanded medical insurance coverage on the labor decisions of rural middle-aged and elderly individuals is advantageous in addressing the consequences of population aging on the labor market. This study utilizes the China Health and Retirement Longitudinal Study (CHARLS) from 2015 and 2018, employs the Difference-in-Differences (DID) approach to empirically investigate the effect of improved medical insurance benefits on the labor decisions of rural middle-aged and elderly individuals. The findings suggest that the increase in medical insurance benefits significantly raises the labor participation rate, labor force participation time, and labor migration among rural middle-aged and elderly individuals, while reducing their willingness for endless labor. Further analysis reveals that the increase of medical insurance benefits directly affects labor decisions by reducing the burden of medical expenses and indirectly influences labor decisions by affecting health conditions. The impact of increased medical insurance benefits on labor supply is more pronounced for the elderly and women compared to middle-aged individuals and men. Based on these findings, this study suggests the continuous improvement of medical insurance benefits for rural residents, the expansion of the scope of medical insurance coverage, and the gradual relaxation of participation restrictions in the medical insurance program.
References
Alfrey, B. (2024). What effect did Medicare Part D have on SSDI Medicare beneficiaries? American Journal of Health Economics, 10(3). Advance online publication. https://doi.org/10.1086/724795
Bonar, J. (1891). The value of labor in relation to economic theory. The Quarterly Journal of Economics, 5(2), 137−164. https://doi.org/10.2307/1882969
Boschmann, E. E. (2011). Job access, location decision, and the working poor: A qualitative study in the Columbus, Ohio metropolitan area. Geoforum, 42(6), 671−682. https://doi.org/10.1016/j.geoforum.2011.06.005
Bradley, C. J., Neumark, D., & Barkowski, S. (2013). Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer. Journal of Health Economics, 32(5), 833−849. https://doi.org/10.1016/j.jhealeco.2013.06.008
Bradley, C. J., Neumark, D., Luo, Z., & Bednarek, H. L. (2007). Employment‐contingent health insurance, illness, and labor supply of women: Evidence from married women with breast cancer. Health Economics, 16(7), 719−737. https://doi.org/10.1002/hec.1191
Brown, W. M., & Scott, D. M. (2012). Human capital location choice: Accounting for amenities and thick labor markets. Journal of Regional Science, 52(5), 787−808. https://doi.org/10.1111/j.1467-9787.2012.00772.x
Cameron, A. C., & Trivedi, P. K. (1991). The role of income and health risk in the choice of health insurance: Evidence from Australia. Journal of Public Economics, 45(1), 1−28. https://doi.org/10.1016/0047-2727(91)90045-4
Chłoń-Domińczak, A., Kotowska, I. E., Magda, I., Smyk-Szymańska, M., Strzelecki, P., & Bolesta, K. (2024). Labour market gender gaps and childcare policies in countries with different social investment strategies. Social Policy & Administration, 58(4), 583−604. https://doi.org/10.1111/spol.13031
Coe, N. B., von Gaudecker, H. M., Lindeboom, M., & Maurer, J. (2012). The effect of retirement on cognitive functioning. Health Economics, 21(8), 913−927. https://doi.org/10.1002/hec.1771
Conte, M. A. (1980). On the economic theory of the labor-managed firm in the short run. Journal of Comparative Economics, 4(2), 173−183. https://doi.org/10.1016/0147-5967(80)90027-X
Currie, J., & Madrian, B. C. (1999). Health, health insurance and the labor market. Handbook of Labor Economics, 3(Part C), 3309−3416. https://doi.org/10.1016/S1573-4463(99)30041-9
Cutler, D. M., & Zeckhauser, R. J. (2000). The Anatomy of health insurance. Handbook of Health Economics, 1(Part A), 563−643. https://doi.org/10.1016/S1574-0064(00)80170-5
Deng, Q., Li, E., & Yang, Y. (2022). Politics, policies and rural poverty alleviation outcomes: Evidence from Lankao County, China. Habitat International, 127, 102631. https://doi.org/10.1016/j.habitatint.2022.102631
Flabbi, L., & Mabli, J. (2018). Household search or individual search: Does it matter? Journal of Labor Economics, 36(1). https://doi.org/10.1086/693864
George, V., & Wilding, P. P. (1984). The impact of social policy. Routledge. https://doi.org/10.4324/9781003390480
Gong, B., & Sims, R. L. (2023). Psychological contract breach during the pandemic: How an abrupt transition to a work from home schedule impacted the employment relationship. Journal of Business Research, 154, 113259. https://doi.org/10.1016/j.jbusres.2022.08.023
Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223−255. https://doi.org/10.1086/259880
Hadley, J. (2003). Sicker and poorer—The consequences of being uninsured: A review of the research on the relationship between health insurance, medical care use, health, work, and income. Medical Care Research and Review, 60(2_suppl), 3S−75S. https://doi.org/10.1177/1077558703254101
Hong, H., & Ning, M. (2020). Does benefit portability of health insurance mitigate the job-lock effect on rural labor force? ——Quasi-natural experimental study on integrated medical insurance system. Journal of Agrotechnical Economics, (11), 83−95. https://link.cnki.net/doi/10.13246/j.cnki.jae.2020.11.007
Huang, J., Qin, D., Jiang, T., Wang, Y., Feng, Z., Zhai, J., Gao, L., Chao, Q., Xu, X., Wang, G., & Su, B. (2019). Effect of fertility policy changes on the population structure and economy of China: From the perspective of the shared socioeconomic pathways. Earth’s Future, 7(3), 250−265. https://doi.org/10.1029/2018EF000964
Huang, X., & Wu, B. (2020). Impact of urban-rural health insurance integration on health care: Evidence from rural China. China Economic Review, 64, 101543. https://doi.org/10.1016/j.chieco.2020.101543
Kobayashi, K., Eweje, G., & Tappin, D. (2024). Changing overwork culture: Stakeholder management for employee wellbeing and social sustainability in large Japanese companies. Corporate Social Responsibility and Environmental Management. https://doi.org/10.1002/csr.2844
Lin, K., Li, Y., Yao, Y., Xiong, Y., & Xiang, L. (2024). The impact of an innovative payment method on medical expenditure, efficiency, and quality for inpatients with different types of medical insurance: Evidence from a pilot city, China. International Journal for Equity in Health, 23(1), 115. https://doi.org/10.1186/s12939-024-02196-2
Liu, H., & Hu, T. (2022). Evaluating the long-term care insurance policy from medical expenses and health security equity perspective: Evidence from China. Archives of Public Health, 80, 3. https://doi.org/10.1186/s13690-021-00761-7
Lu, C., & Wu, A. (2023). Labour market impacts of the equalisation of basic public health and medical services on internal migrants in China. Asia Pacific Viewpoint, 64(3), 375−389. https://doi.org/10.1111/apv.12375
Pourrostami, N., Taghizadeh-Hesary, F., & Mehrizi, F. Z. (2023). Population aging and working hour impacts on occupational accidents: Evidence from Japan. Economic Change and Restructuring, 56, 2621−2644. https://doi.org/10.1007/s10644-023-09526-4
Qin, L., Chen, C. P., Wang, W., & Chen, H. (2021). How migrants get integrated in urban China – The impact of health insurance. Social Science & Medicine, 272, 113700. https://doi.org/10.1016/j.socscimed.2021.113700
Ren, Y., Zhou, Z., Cao, D., Ma, B. H., Shen, C., Lai, S., & Chen, G. (2022). Did the integrated urban and rural resident basic medical insurance improve benefit equity in China? Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 25(9), 1548−1558. https://doi.org/10.1016/j.jval.2022.03.007
Royalty, A. B., & Abraham, J. M. (2006). Health insurance and labor market outcomes: Joint decision-making within households. Journal of Public Economics, 90(8−9), 1561−1577. https://doi.org/10.1016/j.jpubeco.2005.10.001
Rui, D. (2019). The availability of health rights and labor supply of migrant workers: Evidence from dynamic monitoring of migrant population. Chinese Rural Economy, 4, 92−110. https://www.cabidigitallibrary.org/doi/full/10.5555/20193227063
Shen, Z., Parker, M., Brown, D., & Fang, X. (2017). Effects of public health insurance on labor supply in rural China. China Agricultural Economic Review, 9(4), 623−642. https://doi.org/10.1108/CAER-12-2016-0194
Swanson, J. A. (1994). The moral economy of labor: Aristotelian themes in economic theory. By James Bernard Murphy. New Haven: Yale University Press, 1993. 244p. $25.00. American Political Science Review, 88(3),744−745. https://doi.org/10.2307/2944819
Wang, Z., Chen, Y., Pan, T., Liu, X., & Hu, H. (2019). The comparison of healthcare utilization inequity between URRBMI and NCMS in rural China. International Journal for Equity in Health, 18(90). https://doi.org/10.1186/s12939-019-0987-1
Wang, Z., Wu, Z., & Yuan, Y. (2024). We’ve got you covered! The effect of public health insurance on rural entrepreneurship in China. Journal of Public Economics, 235, 105150. https://doi.org/10.1016/j.jpubeco.2024.105150
World Bank Group. (n.d.). World Development Indicators: Population dynamics. https://wdi.worldbank.org/table/2.1
Xue, Z., & Li, B. (2022). The impact of the integration of urban and rural medical insurance on migrant workers’ overwork: Evidence from China. Frontiers in Public Health, 10, 934524. https://doi.org/10.3389/fpubh.2022.934524
Yang, D., Acharya, Y., & Liu, X. (2022). Social health insurance consolidation and urban-rural inequality in utilization and financial risk protection in China. Social Science & Medicine, 308, 115200. https://doi.org/10.1016/j.socscimed.2022.115200
Yip, W., Fu, H., Chen, A. T., Zhai, T., Jian, W., Xu, R., Pan, J., Hu, M., Zhou, Z., Chen, Q., Mao, W., Sun, Q., & Chen, W. (2019). 10 years of health-care reform in China: progress and gaps in Universal Health Coverage. The Lancet, 394(10204), 1192−1204. https://doi.org/10.1016/S0140-6736(19)32136-1
Zhou, D., Jin, W., & Wu, H. (2023). How does urban-rural integrated medical insurance affect labour supply of migrant workers [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-2930199/v1
Zhou, Y., Wang, H., & Qiu, H. (2023). Population aging reduces carbon emissions: Evidence from China’s latest three censuses. Applied Energy, 351, 121799. https://doi.org/10.1016/j.apenergy.2023.121799
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