Journal of Family History, Ahead of Print.
This article examines the reasons for the underdevelopment of commercial health insurance as a family risk-sharing mechanism, from the viewpoint of traditional Chinese clan culture. Using genealogical data to create city-level indicators of clan culture, this study investigates its impact on the demand for family-oriented commercial health insurance. The results indicate a negative correlation between the intensity of clan culture and the demand for family commercial health insurance, and a smaller percentage of income allocated to health insurance premiums in areas with stronger clan culture. This crowding-out effect primarily occurs through bilateral transfer payments encouraged by mutual aid among clan members.