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The spillover effect of National Health Insurance on household consumption patterns: Evidence from a natural experiment in Taiwan

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  • Sheu, Ji-Tian
  • Lu, Jui-fen Rachel

Abstract

While providing financial risk protection was one of the major aims of introducing a National Health Insurance (NHI) program in Taiwan in 1995, one may also wonder how the households may exploit resources freed up and available to them as a result of reduced exposure to risk due to health insurance. This paper aims at studying and evaluating the impact of social insurance on these differing household consumption patterns. A differences-in-differences estimation model was applied to a sample of 17,899 households from the 1993–2000 Taiwan Survey of Family Income and Expenditure to assess the NHI's impact. This effect was evaluated by the changes in the proportion of the consumption expenditure devoted to medical items and non-medical items in the post-NHI period (1996–2000) compared to the pre-NHI period (1993–1994). Our study found that spending related to the improvement of housing conditions (rental and water bills) had the most significant increase, 1.87% (in the share). Furthermore, examining the NHI impact across socioeconomic status (SES) strata (in terms of income and education levels), our study found that households with the lowest SES experienced the largest increase in spending share (2.16%) for rental and water bills, and the least drop (0.64%) on education items. Recognizing how households can exploit the potential benefits associated with NHI provision could enable the government to devise specific policy tools to facilitate better targeting of investment decisions with limited resources available for less well-off households.

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  • Sheu, Ji-Tian & Lu, Jui-fen Rachel, 2014. "The spillover effect of National Health Insurance on household consumption patterns: Evidence from a natural experiment in Taiwan," Social Science & Medicine, Elsevier, vol. 111(C), pages 41-49.
  • Handle: RePEc:eee:socmed:v:111:y:2014:i:c:p:41-49
    DOI: 10.1016/j.socscimed.2014.04.006
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    1. Koch, Steven & Alaba, Olufunke, 2010. "On health insurance and household decisions: A treatment effect analysis," Social Science & Medicine, Elsevier, vol. 70(2), pages 175-182, January.
    2. Jonathan Gruber & Aaron Yelowitz, 1999. "Public Health Insurance and Private Savings," Journal of Political Economy, University of Chicago Press, vol. 107(6), pages 1249-1274, December.
    3. Rachel Lu, Jui-Fen & Chiang, Tung-Liang, 2011. "Evolution of Taiwan’s health care system," Health Economics, Policy and Law, Cambridge University Press, vol. 6(1), pages 85-107, January.
    4. Chou, Y. J. & Staiger, Douglas, 2001. "Health insurance and female labor supply in Taiwan," Journal of Health Economics, Elsevier, vol. 20(2), pages 187-211, March.
    5. Boyle, Melissa A. & Lahey, Joanna N., 2010. "Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion," Journal of Public Economics, Elsevier, vol. 94(7-8), pages 467-478, August.
    6. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    7. Chou, Shin-Yi & Liu, Jin-Tan & Hammitt, James K., 2003. "National Health Insurance and precautionary saving: evidence from Taiwan," Journal of Public Economics, Elsevier, vol. 87(9-10), pages 1873-1894, September.
    8. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    9. James W. Hardin & Joseph W. Hilbe, 2012. "Generalized Linear Models and Extensions, 3rd Edition," Stata Press books, StataCorp LP, edition 3, number glmext, March.
    10. Chung-Ming Kuan & Chien-Liang Chen, 2013. "Effects of National Health Insurance on precautionary saving: new evidence from Taiwan," Empirical Economics, Springer, vol. 44(2), pages 921-943, April.
    11. James L. Seale & Anita Regmi, 2006. "Modeling International Consumption Patterns," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 52(4), pages 603-624, December.
    12. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    13. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    14. Shin-Yi Chou & Jin-Tan Liu & Cliff J. Huang, 2004. "Health insurance and savings over the life cycle-a semiparametric smooth coefficient estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(3), pages 295-322.
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    5. Chen, Hua & Ding, Yugang & Tang, Lin & Wang, Lizhen, 2022. "Impact of urban–rural medical insurance integration on consumption: Evidence from rural China," Economic Analysis and Policy, Elsevier, vol. 76(C), pages 837-851.

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