You Jing
School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China.
Health Econ. 2016 May;25(5):543-58. doi: 10.1002/hec.3168. Epub 2015 Mar 17.
This paper assesses the causal impact on child health of borrowing formal microcredit for Chinese rural households by exploiting a panel dataset (2000 and 2004) in a poor northwest province. Endogenous borrowing is controlled for in a dynamic regression-discontinuity design creating a quasi-experimental environment for causal inferences. There is causal relationship running from formal microcredit to improved child health in the short term, while past borrowing behaviour has no protracted impact on subsequent child health outcomes. Moreover, formal microcredit appears to be a complement to health insurance in improving child health through two mechanisms-it enhances affordability for out-of-pocket health care expenditure and helps buffer consumption against adverse health shocks and financial risk incurred by current health insurance arrangements. Government efforts in expanding health insurance for rural households would be more likely to achieve its optimal goals of improving child health outcomes if combined with sufficient access to formal microcredit.
本文利用中国西北一个贫困省份的面板数据集(2000年和2004年),评估了中国农村家庭借贷正规小额信贷对儿童健康的因果影响。在动态回归间断设计中控制了内生性借贷,为因果推断创造了一个准实验环境。短期内,正规小额信贷与儿童健康改善之间存在因果关系,而过去的借贷行为对随后的儿童健康结果没有长期影响。此外,正规小额信贷似乎是健康保险在改善儿童健康方面的一种补充,通过两种机制实现——它提高了自费医疗支出的可承受性,并有助于缓冲当前医疗保险安排所带来的健康冲击和财务风险对消费的影响。如果能结合充足的正规小额信贷渠道,政府为农村家庭扩大医疗保险的努力将更有可能实现改善儿童健康结果的最优目标。