N ° 2010 - 10 Decrease in the healthcare demand in rural China : A side effect of the industrialization process ?

In China, with the economic reforms leading to the raise in agricultural productivity, the rural healthcare organisation has been weakened. In a 1991-2006 database, a decrease in the healthcare demand is observed. If many papers study the effect of the insurance system (NCMS) on the healthcare demand, other factors explaining the healthcare demand have not received much research attention yet. We use a matching and difference in difference model to correct for the selection bias on insurance effect. If the income level and insurance enrollment plays a major role on the healthcare demand, we shed light on the peer effect of the industrialization process and the changes affecting healthcare facilities. In a context of healthcare price widely increasing, the change in villagers working activity leads to an increase in the inequality of healthcare access (due to inequality of wage, mobility, and private insurance). The result is a reduction and sometimes worse, an exclusion from the healthcare access for the poorest. A public policy has to be conducted to support farmers, in particular in areas where a significant part of the village inhabitants have an industrial activity.