부산대학교 도서관

Since the reform and opening up in the 1970s, China has turned into the world′s 2nd largest by GDP. During that time, the Chinese social security system has also been greatly changed. In the case of basic medical insurance system which is composed of Urban Employee Basic Medical Insurance, New Rural Cooperative Medical Insurance, and Urban Resident Basic Medical Insurance, the total coverage of medical insurance has dramatically expanded from 8.4% in 2003 to 97.5% in 2014. The aim of this paper is to investigate the state of equity, which is the central value of social security system. There are so many controversies in concept and criterion for equity. But in this paper, equity is understood as a subordinate concept and coordinating principle of equality. In applying to the Chinese medical insurance system, equity is divided into the following two aspects: 1) ex ante equity which is similar to equality of opportunity; and 2) ex post equity which is similar to equality of outcome. Ex ante equity is operationalized as eligibility and compulsoriness of enrollment, equal contribution and average medical insurance funds per capita, and equal distribution of medical resources between rural and urban areas. Ex post equity is operationalized as equal rate of insurance benefits, equal level of insurance benefits, and the equal ratio of medical expenditure to income. According, research findings, since the expansion of the medical insurance system in 2003, people have less benefitted than urban people. Thus, this paper concludes that the Chinese medical insurance system has the problem of disparity that is against the critical value of the system itself. In addition, it expresses a concern about the dysfunction of the medical insurance system, thus contributing to working as a social stratification mechanism, and reflecting and reinforcing existing inequalities or cleavages in the Chinese society.