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| 1 |
ID:
163513
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| Summary/Abstract |
This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey1 we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.
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| 2 |
ID:
187133
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| Summary/Abstract |
The presence of private providers in the Indian healthcare sector remains one of the most debated issues. This article attempts to contribute to this debate from the angle of the ultimate goal of healthcare provision—a healthy population. We explore whether private sector presence (PSP) has improved the general health status of the people. We develop a theoretical argument to hypothesize that PSP in India would lead to better health status through the route of competition-driven quality, which in turn could lead to adverse economic consequences. We use district-level secondary data from government sources to confirm our hypotheses using robust tools of applied econometrics, correcting for serious problems of endogeneity. Constructing a district-level index of PSP, we identify distinct spatial/geographical clusters, explained by socio-economic prosperity as well as demonstration effect. We also find a robust positive association between PSP and general health outcomes, accompanied by an adverse economic consequence of rising catastrophic out-of-pocket expenditure. In terms of policy, the article concludes that rather than restricting the growth of the private sector, the government must strengthen the quality of the existing public healthcare delivery system and ensure effective monitoring and regulation.
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