Three essays on rural-urban integration in China : health insurance, urban identity, and social justice

Abstract

This dissertation, comprising three essays, examines the ongoing rural-urban integration in China and its impact on individual citizens. The first essay traces the changing configuration of the Chinese health insurance system from 1949 to 2020. From a policy perspective, the study identifies four stages throughout the health insurance reform history and examines the most recent integration reforms based on an analysis of policies from 31 provinces. The findings highlight the need for systematic adjustments of the hukou-based system to achieve full integration. The second essay builds a theoretical framework to understand the way social insurance enrolment influences urban identification. Using data from the 2018 Urbanization and Quality of Life Survey, it assesses the efficacy of four types of social insurance in promoting urban identification. The study reveals the divergent effects resulting from the institutional boundary formed along China's long-lasting rural-urban disparities. The third essay combines the 2015 CGSS data and the Index of Rural-urban Development Integration of 28 provinces to investigate the influence of rural-urban integration on individuals' perception of social justice. The results suggest that building a more equitable social development system in education, health insurance, and social security would mitigate multi-dimensional inequities, promote social mobility, and boost a sense of social justice. The three essays contribute to a better understanding of China's ongoing rural-urban integration reforms and how they affect individuals' identity and perception in the context of social transitions and institutional adjustments.