The Evaluation of the Effect of the Critical Illness Insurance System on the Household Financial Burden
DOI: https://doi.org/10.62517/jmsd.202612304
Author(s)
Yinxin Chen
Affiliation(s)
Zhongnan University of Economics and Law, Wuhan, Hubei, China
Abstract
This study addresses the growing need to evaluate the effectiveness of China's Critical Illness Insurance (CII) system, highlighting gaps in existing research regarding its comprehensive impact on household financial burdens under evolving demographic and economic conditions. A qualitative research approach combining literature review, policy text analysis, and case study methods was employed to assess the system's operational mechanisms and outcomes. The study utilized data from empirical research, government reports, and insurance reimbursement records covering multiple Chinese cities and populations. Results indicate that while the CII system significantly reduces out-of-pocket medical expenses and alleviates poverty caused by illness, challenges remain in coverage disparities and income protection. These findings contribute to the theoretical understanding of healthcare social security systems and provide practical recommendations for enhancing policy design, aiming to establish a more integrated and equitable healthcare protection framework in China.
Keywords
Critical Illness Insurance; Household Financial Burden; Healthcare Security System
References
[1] Hu Yangmu, Li Lu, Du Ling, Fan Yangdong. The Effectiveness of Critical Illness Insurance and Its Influencing Factors in an Underdeveloped Region [J]. Medicine and Society, 2024, 37(12), 117-123.
[2] Chen Zhongnan, Sun Shengmin. Research on the Poverty Reduction Effects of Critical Illness Insurance: An Empirical Analysis Based on CFPS Data [J]. Journal of Jinan University (Philosophy and Social Sciences Edition), 2022, (3), 24-39.
[3] Fang P, Pan Z, Zhang X, et al. The effect of critical illness insurance in China[J]. Medicine, 2018, 97(27): e11362
[4] Hua Yazhou. Research on Reform and Development Strategies for China's Major Illness Insurance System for Urban and Rural Residents [D]. Hubei: Wuhan University, 2018.
[5] Sun, JL;Tao, R,Wang,L;Jin,LM. Does Social Medical Insurance Achieve a Poverty Reduction Effect in China?.[J].FRONTIERS IN PUBLIC HEALTH,2022,(9)
[6] Thomas C. Buchmueller, Kevin Grumbach, Richard Kronick, James G. Kahn. The Effect of Health Insurance on Medical Care Utilisation and Implications for Insurance Expansion: A Review of the Literature [J]. Medical Care Research and Review, 2005, (62): 3-30.
[7] Tian Wenhua. Institutional Arrangements and Experiential Insights of Critical Illness Insurance in Typical Developed Countries [J]. People's Forum, 2025, (13), 69-73.
[8] Wang Chaoqun, Liu Xiaoqing, Liu Xiaohong, Gu Xuefei. The Impact of Critical Illness Insurance on Catastrophic Health Expenditure Among Urban and Rural Households: An Analysis Based on Survey Data from a Selected City [J]. China Health Services Management, 2014, (6), 433-437.
[9] Yue Wei, Wang Xiong, Zhang Qiang. Health Risks, Medical Insurance and Household Financial Vulnerability [J]. China Industrial Economics, 2021, (10), 175-192.
[10] Xu Xian. Operational Models and Development Directions of China's Critical Illness Insurance [J]. People's Forum, 2025, (4), 21-23.
[11] Zhang Jianjun, Liu Kaiwei. A Multi-Party Game Analysis of Health Insurance Based on the ‘Zhanjiang Model' of PICC Health Insurance [J]. Insurance Research, 2011(3): 102-107.
[12] Peng Yunjia, “2023 China Urban and Rural Critical Illness Insurance Benefited 11.56 Million People,” Xinhua News, April 3, 2024 7h, http://www.xinhuanet.com/20240403/67dfe880a13f46fc9322bea8dda473d2/c.html
[13] Zhang Jianjun, Liu Kaiwei. A Multi-Party Game Analysis of Health Insurance Based on the ‘Zhanjiang Model' of PICC Health Insurance [J]. Insurance Research, 2011(3): 102-107.
[14] Fang P, Pan Z, Zhang X, et al. The effect of critical illness insurance in China[J]. Medicine, 2018, 97(27): e11362
