Rural Residents’ Preferences for Inclusive Commercial Health Insurance in China

A recent study conducted among 520 rural households in Zhucheng County, China, examines rural residents’ preferences and willingness to pay for inclusive commercial health insurance. The study's goal is to inform the development of sustainable and affordable health insurance systems that protect against catastrophic health expenditures, a critical component of Universal Health Coverage (UHC). Using a discrete choice experiment, researchers identified key insurance plan attributes that significantly impact rural residents' preferences, including government participation, reimbursement ratios, coverage for special medications, and premium costs, with government involvement having the greatest influence. The deductible level did not show significant influence on preferences. The study found that the optimal insurance plan configuration could increase predicted enrollment probability by 99.6%, highlighting the importance of government responsibility in enhancing rural insurance uptake. Additional effective measures include ensuring equitable coverage regardless of preexisting conditions, optimizing benefit design, and setting reasonable premiums and deductibles. These findings offer actionable insights for policymakers and insurance providers aiming to increase health insurance enrollment in rural areas and can inform UHC strategies globally through public-private insurance partnerships. The research builds on existing evidence of health insurance coverage disparities in rural China and aligns with international efforts to advance UHC financing and risk protection mechanisms. Understanding consumer preferences through discrete choice experiments facilitates the design of tailored insurance products that meet rural populations' needs, potentially reducing out-of-pocket health spending and improving access to care. The study emphasizes government participation as a critical factor in insurance attractiveness, suggesting policy reforms to strengthen public-private collaboration in rural health insurance markets. This research contributes to the ongoing discourse on health system financing, equity, and sustainability in low-resource settings and offers transferable lessons for similar contexts worldwide.