By Zeen He

Using a non-parametric fuzzy regression discontinuity design and leveraging data from the China Health and Retirement Longitudinal Study (CHARLS), this paper explores the impact of public and private pension schemes on health service utilization and health outcomes among urban and rural individuals in China. Our estimates show that receipt of public pensions, particularly the Urban Employee Pension Scheme (UEPS) and Public Employee Pension Scheme (PEPS), significantly improves selfreported health, mental health (CES-D scores), and physical health (ADL scales), especially among urban males who are married and educated. However, there are no significant effects on healthcare utilization among urban people. Similarly, private pension schemes have positive impacts on health outcomes. Moreover, social pensions, the New Rural Pension Scheme (NRPS), increase healthcare utilization (inpatient/outpatient) and corresponding healthcare spending of the rural population, particularly among married and low-educated male residents. Specifically, in urban China, public pension (UEPS/PEPS) receipts have two spillover effects: spousal and inter-generational. These effects manifest in terms of health improvements, intergenerational care, and intra-family transfers. These findings exhibit heterogeneity across gender, rural-urban differences, hukou status, and marital status. Additionally, the health effects stemming from urban pension schemes can be explained by retirement, providing more leisure time for males and grandparental childcare responsibilities for females. However, the positive effect on healthcare use of rural males and the null effect for rural females are driven by the pure income effect of household joint financial pooling under the NRPS and female altruism. Finally, we find that integrating NRPS and URPS increased migration, non-agricultural employment, and health of nonpensioners, with no effect on rural pensioners.

Source SSRN