Social Health Insurance vs. Tax-Financed Health Systems--Evidence from the OECD
AbstractThis paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spending, amenable mortality, and labor market outcomes. The paper uses regression-based generalizations of difference-in-differences and instrumental variables to address the possible endogeneity of a country's health system. It finds that adopting social health insurance in preference to tax financing increases per capita health spending by 3-4 percent, reduces the formal sector share of employment by 8-10 percent, and reduces total employment by as much as 6 percent. For the most part, social health insurance adoption has no significant impact on amenable mortality, but for one cause--breast cancer among women--social health insurance systems perform significantly worse, with 5-6 percent more potential years of life lost.
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Bibliographic InfoPaper provided by The World Bank in its series Policy Research Working Paper Series with number 4821.
Length: 39 pages
Date of creation: 01 Jan 2009
Date of revision:
Social health insurance; labor markets; health finance; health sector reform.;
This paper has been announced in the following NEP Reports:
- NEP-ALL-2009-02-14 (All new papers)
- NEP-HEA-2009-02-14 (Health Economics)
- NEP-IAS-2009-02-14 (Insurance Economics)
- NEP-LAB-2009-02-14 (Labour Economics)
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