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The Impact of Universal Health Insurance on Catastrophic and Out-of-Pocket Health Expenditures in Mexico: a Model with an Endogoenous Treatment Variable

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Author Info
Galarrága, O
Sosa-Rubí, S. G
Salinas, A
Sesma, S
Abstract

The main goal of Seguro Popular is to improve the financial protection of the uninsured population against excessive health expenditures. Seguro Popular (SP) covers a variety of preventive and curative procedures, as well as medicines, and hospital care for the poorest segment of the Mexican population. Data: This paper estimates the impact of Seguro Popular on catastrophic health expenditures, as well as out-of-pocket health expenditures, from three different sources: National Household Survey of Income and Expenditures (ENIGH 2006); National Health and Nutrition Survey (ENSANUT 2006); and SP Impact Evaluation Survey. Methods: We first estimate naive probit models, and then compare them against bivariate probit models which use instrumental variables that take advantage of the specific SP implementation mechanisms to address the endogeneity of insurance selection choices. Results: No effect on catastrophic health expenditures is observed in the ENIGH sample. However, we find a statistically significant effect on the reduction of household’s expenditures on medicines and outpatient care. On the other hand, Seguro Popular reduces the probability of catastrophic health expenditures using the other two datasets: SP Impact Evaluation Survey, and ENSANUT. We also observe a reduction of the probability of expenditures on medicines and outpatient care among the SP insured families.

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Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 08/12.

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Date of creation: Jun 2008
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Handle: RePEc:yor:hectdg:08/12

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Related research
Keywords: catastrophic health expenditures; health insurance; instrumental variables; non-linear methods; Mexico;

Find related papers by JEL classification:
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
I38 - Health, Education, and Welfare - - Welfare and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

This paper has been announced in the following NEP Reports:

References listed on IDEAS
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  1. Joshua Angrist & Alan Krueger, 2001. "Instrumental Variables and the Search for Identification: From Supply and Demand to Natural Experiments," Working Papers 834, Princeton University, Department of Economics, Industrial Relations Section.. [Downloadable!]
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  2. Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May. [Downloadable!] (restricted)
    Other versions:
  3. Parker, Susan W. & Wong, Rebeca, 1997. "Household income and health care expenditures in Mexico," Health Policy, Elsevier, vol. 40(3), pages 237-255, June. [Downloadable!] (restricted)
  4. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low-income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857. [Downloadable!]
  5. David McKenzie, 2005. "Measuring inequality with asset indicators," Journal of Population Economics, Springer, vol. 18(2), pages 229-260, 06. [Downloadable!] (restricted)
  6. Esther Duflo, 2001. "Schooling and Labor Market Consequences of School Construction in Indonesia: Evidence from an Unusual Policy Experiment," American Economic Review, American Economic Association, vol. 91(4), pages 795-813, September. [Downloadable!] (restricted)
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  7. repec:fth:prinin:455 is not listed on IDEAS
  8. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non-profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616. [Downloadable!]
  9. Menno Pradhan & Nicholas Prescott, 2002. "Social risk management options for medical care in Indonesia," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 431-446. [Downloadable!]
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