Social health insurance and inequality in China

Stream: International social policy
Date: Tuesday, 10 September 2019
Time: 10.55 am – 12.35 pm


In the past two decades, social health insurance coverage has achieved significant progress in China. Nowadays, almost all Chinese citizens are covered by social health insurance which includes three schemes (i.e. the rural new cooperative medical scheme, urban resident-based basic medical insurance scheme, and urban employee-based basic medical insurance scheme).

By using the multilevel logistic regression models to analyse a survey of 9,768 samples conducting in eight Chinese provinces in 2014, we argue that despite China has achieved the universal health insurance coverage, it has a strong feature of inequality and social stratification, which is evidenced from three aspects:
1) the participants of different types of health insurance highly depend on their hukou (household registration) and occupational status
2) the level of benefits varied among different types of health insurance recipients
3) migrants are the largest group of people seeking self-medication which is mainly due to the non-portable health insurance.

Therefore, unlike the findings of existing research in the OECD countries, whose main determinants of health inequalities are the social class, income and education, we assert the key determinants in China are hukou, occupation, and migration status.


Li Sun, University of Leeds
Dr Li Sun is a lecturer in Sociology & Social Policy at the University of Leeds. She also serves as a consultant to the UN, World Bank, and OECD, as well as various government offices in China, the UK and the Netherlands. Her research interests focus on social policy, rural-urban migration, and housing issues in China.

Juntao Lyu (Presenter), University of Leeds
Juntao Lyu is a PhD candidate at the School of Sociology & Social Policy at the University of Leeds. His research interest is the sociology of health and illness and population health. His current PhD research project is about Chinese internal migrant workers dealing with health and illness problems in urban settings.

Ying Zhao, Renmin University of China
Ying Zhao is a PhD candidate at the School of Labor and Human Resources at the Renmin University of China. Her research explores social security and health insurance in China.

Tao Liu, University of Duisburg-Essen
Tao Liu is Professor of Comparative Sociology and Chinese Society at the Institute of East Asian Studies and at the Institute of Sociology in the Faculty of Social Sciences, University of Duisburg-Essen, Germany. He has published articles on accident insurance, social assistance, elderly care, and old age social security in China.