Abstract: Based on China’s provincial dynamic panel data from 2002 to 2018, this paper employs the Difference GMM and other methods to empirically test the health performance of China’s social medical insurance system and its regional heterogeneity. The findings show that as an important medical costs sharing mechanism, the medical insurance can improve the health status of residents significantly through its improvement in its popularity, financing scale and reimbursement level. Because there are some differences in the medical service demand elasticity of the residents with different economic positions, the health performance of the medical insurance system presents significant regional heterogeneity; generally, a stronger health protection effect can be found in the underdeveloped areas. Furth analysis from the perspectives of geographical location and insurance type indicates that the medical insurance has a stronger health promotion effect on the residents in the western region, and the basic medical insurance scheme for urban employees with a higher reimbursement level has the same better health performance; meanwhile, it exhibits a greater regional heterogeneity of “pro-poverty”.

Key words: social medical insurance system, health performance, regional heterogeneity, difference GMM, health equity