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A “politically robust” experimental design for public policy evaluation, with application to the Mexican Universal Health Insurance program

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Author Info

  • Gary King

    (Harvard University)

  • Emmanuela Gakidou

    (Harvard University)

  • Nirmala Ravishankar

    (Harvard University)

  • Ryan T. Moore

    (Harvard University)

  • Jason Lakin

    (Harvard University)

  • Manett Vargas

    (National Commission for Social Protection in Health, Ministry of Health, Mexico)

  • Martha Mar�a Téllez-Rojo

    (Instituto Nacional de Salud P�blica (National Institute of Public Health), Mexico)

  • Juan Eugenio Hernández �vila

    (Instituto Nacional de Salud P�blica (National Institute of Public Health), Mexico)

  • Mauricio Hernández �vila

    (Undersecretary for Prevention and Health Promotion, Secretar�a de Salud (Ministry of Health), Mexico)

  • Héctor Hernández Llamas

    (Conestadistica)

Abstract

We develop an approach to conducting large-scale randomized public policy experiments intended to be more robust to the political interventions that have ruined some or all parts of many similar previous efforts. Our proposed design is insulated from selection bias in some circumstances even if we lose observations; our inferences can still be unbiased even if politics disrupts any two of the three steps in our analytical procedures; and other empirical checks are available to validate the overall design. We illustrate with a design and empirical validation of an evaluation of the Mexican Seguro Popular de Salud (Universal Health Insurance) program we are conducting. Seguro Popular, which is intended to grow to provide medical care, drugs, preventative services, and financial health protection to the 50 million Mexicans without health insurance, is one of the largest health reforms of any country in the last two decades. The evaluation is also large scale, constituting one of the largest policy experiments to date and what may be the largest randomized health policy experiment ever. © 2007 by the Association for Public Policy Analysis and Management

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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Journal of Policy Analysis and Management.

Volume (Year): 26 (2007)
Issue (Month): 3 ()
Pages: 479-506

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Handle: RePEc:wly:jpamgt:v:26:y:2007:i:3:p:479-506

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Web page: http://www3.interscience.wiley.com/journal/34787/home

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References

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  1. Holzer, Harry J. & Quigley, John M. & Raphael, Steven, 2003. "Public Transit and the Spatial Distribution of Minority Employment: Evidence from a Natural Experiment," University of California Transportation Center, Working Papers qt1x09f824, University of California Transportation Center.
  2. Steven Glazerman & Daniel Mayer & Paul Decker, 2006. "Alternative routes to teaching: The impacts of Teach for America on student achievement and other outcomes," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 25(1), pages 75-96.
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  4. Elizabeth Ty Wilde & Robinson Hollister, 2007. "How close is close enough? Evaluating propensity score matching using data from a class size reduction experiment," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 26(3), pages 455-477.
  5. John List & David Reiley, 2008. "Field experiments," Artefactual Field Experiments 00091, The Field Experiments Website.
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  7. David H. Greenberg & Charles Michalopoulos & Philip K. Robin, 2006. "Do experimental and nonexperimental evaluations give different answers about the effectiveness of government-funded training programs?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 25(3), pages 523-552.
  8. Thomas S. Dee & Benjamin J. Keys, 2004. "Does merit pay reward good teachers? Evidence from a randomized experiment," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 23(3), pages 471-488.
  9. William G. Howell, 2004. "Dynamic selection effects in means-tested, urban school voucher programs," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 23(2), pages 225-250.
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Cited by:
  1. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2), pages 181-188.
  2. Rebecca L. Thornton & Laurel E. Hatt & Erica M. Field & Mursaleena Islam & Freddy Solís Diaz & Martha Azucena González, 2010. "Social security health insurance for the informal sector in Nicaragua: a randomized evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 181-206, September.
  3. Azuara, Oliver, 2011. "Effect of universal health coverage on marriage, cohabitation and labor force participation," MPRA Paper 35074, University Library of Munich, Germany.
  4. Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer, vol. 11(5), pages 437-447, October.
  5. Spenkch, Jörg L., 2011. "Adverse selection and moral hazard among the poor: evidence from a randomized experiment," MPRA Paper 31443, University Library of Munich, Germany.
  6. Azuara, Oliver & Marinescu, Ioana, 2011. "Informality and the expansion of social protection programs," MPRA Paper 35073, University Library of Munich, Germany.
  7. Rodrigo Barros, 2008. "Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico," Discussion Papers 09-002, Stanford Institute for Economic Policy Research.

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