The High-Quality Development of Commercial Health Insurance: Measurement and Discussion Based on 2011-2020 China’s Provincial Panel Data

Abstract

Objective: The objective of this study is to assess the high-quality development of commercial health insurance in mainland China, and discuss its effectiveness and efficiency in the sense of coordination with economic development. More specifically, the objective is threefold: (1) to construct an all-round assessment matrix with a compound index to measure the high-quality development of commercial health insurance; (2) to track the dynamic evolution of regional commercial health insurance development, as well as the regional disparities; (3) to measure the coupling coordinated development level between regional commercial health insurance and regional economics.
Methods: The study was supported by the 2011-2020 provincial panel data from China Statistical Yearbook、China City Statistical Yearbook、Yearbook of China’s Insurance、Almanac of China’s Finance and Banking、China Population and Employment Statistics Yearbook、China’s environmental Yearbook. The analytic hierarchy process - entropy weight method was applied to analyze high-quality development of commercial health insurance and high-quality economic development. For study on regional disparities, the Theil index was used for the analysis. The coupling coordination degree model was constructed to measure the coupling coordinated development level.
Results: (i) There were around one third regions that had achieved superior commercial health insurance development and coupling coordination between commercial health insurance and economics than national average, and most of them were in the east/coastal area. (ii) The overall improvement of coordination relationship was significantly inferior to that of commercial health insurance development, which reflects the difficulty of achieving coupling coordinated development between commercial health insurance and economics. (iii) The nationwide population-weighted Theil index decreased by around 50% over the past decade, which indicates that regional disparity has been reduced remarkably. The decomposition results indicate that the total Theil was dominated by the intra-regional difference and thus it can explain a significant portion of the overall inequality. (iv) The nationwide coupling coordination degree was quite stable before 2016, and got improved rapidly since 2017. Most regions had a low coupling coordinated development level in 2011 and 15 of them finally reached medium- or high- level in 2019. (v) The COVID-19 pandemic had obvious adverse impact on commercial health insurance development and coordination relationship between commercial health insurance and economics.
Conclusion: The existing assessment is limited in that it emphasizes partially the regional disparities in an absolute sense. In contrast, the all-round assessment matrix and the coordination analysis in our study can provide decision makers with reliable measurement. It is necessary to continuously monitoring the high-quality commercial health insurance development index and the coupling coordination degree. As such, the appropriate health insurance industry policy could be developed accordingly. As the most important supplements to social security system, commercial health insurance and commercial pension scheme should serve local economic society development, effectively and efficiently.