Can Social Health Insurance Improve Mental Health? An Analysis of Supplementary High-Cost Illness Insurance in China

Wei Yang, King's College London

Substantial evidence indicates that Social Health Insurance (SHI) improves access to care by protecting people against health shocks. In 2015, China launched the Supplementary High-Cost Illness Insurance (SHCII) program, an innovative extension of its existing SHI designed to provide additional financial support to individuals facing catastrophic illnesses. Although the SHCII has significantly improved healthcare access and reduced the financial burdens for economically disadvantaged individuals, evidence on the program’s impact on the mental health of its beneficiaries remains scant. This study aims to evaluate the effects of SHCII on the mental well-being of middle-aged and older individuals. Drawing data from the China Health and Retirement Longitudinal Study 2011, 2013, 2015, and 2018, this research employs propensity score matching with the time-varying difference-in-differences method to investigate SHCII's influence on mental health. Results indicate that SHCII significantly lowers depressive symptoms, particularly among older individuals with poor self-rated health, chronic diseases, and lower household income. Our findings suggest that SHCII has a notable positive impact on mental health outcomes. We also recommend that governments consider expanding the programme to other areas within China, focusing especially on the most economically disadvantaged segments of the population.

Keywords: Economic Demography, Population Policies

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