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The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan

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  • Chou, Shin-Yi
  • Grossman, Michael
  • Liu, Jin-Tan

Abstract

We estimate the impacts of the introduction of National Health Insurance in Taiwan in March 1995 on infant survival. Prior to NHI, government workers (the control group) possessed health insurance policies with comprehensive coverage for births and infant medical care services. Private sector industrial workers and farmers (the treatment groups) lacked this coverage. All households received coverage in 1995. Since stringent requirements for reporting births introduced in 1994 produced artificial upward trends in early infant deaths, we focus on postneonatal mortality. The introduction of NHI led to reductions in this rate for infants born in farm households but not for infants born in private sector households. For the former group, the rate fell by between 0.3 and 0.6 deaths per thousand survivors or by between 8 and 16%. A large decline of between 3.4 and 6.8 deaths occurred for pre-term infants—a drop of between 20 and 41%.

Suggested Citation

  • Chou, Shin-Yi & Grossman, Michael & Liu, Jin-Tan, 2014. "The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan," Journal of Development Economics, Elsevier, vol. 111(C), pages 75-91.
  • Handle: RePEc:eee:deveco:v:111:y:2014:i:c:p:75-91
    DOI: 10.1016/j.jdeveco.2014.08.004
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    Cited by:

    1. Shin-Yi Chou & Jin-Tan Liu & Michael Grossman & Ted Joyce, 2010. "Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan," American Economic Journal: Applied Economics, American Economic Association, vol. 2(1), pages 33-61, January.
    2. Halla, Martin & Liu, Chia-Lun & Liu, Jin-Tan, 2019. "The Effect of Superstition on Health: Evidence from the Taiwanese Ghost Month," IZA Discussion Papers 12066, Institute of Labor Economics (IZA).
    3. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," Tinbergen Institute Discussion Papers 13-067/V, Tinbergen Institute.
    4. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    5. Emmanuelle Lavaine & Matthew Neidell, 2017. "Energy Production and Health Externalities: Evidence from Oil Refinery Strikes in France," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 447-477.
    6. Rana Ejaz Ali Khan & Muhammad Ali Raza, 2016. "Utilization of prenatal-care in India: an evidence from IDHS," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 18(1), pages 175-201, October.
    7. Chou, Shin-Yi & Grossman, Michael & Liu, Jin-Tan, 2014. "The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan," Journal of Development Economics, Elsevier, vol. 111(C), pages 75-91.
    8. repec:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0169-z is not listed on IDEAS
    9. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    10. Meng-Wen Tsou & Jin-Tan Liu & Kuang-Hsien Wang, 2014. "Impact of Low Birth Weight Child on Maternal Labour Force Participation: Evidence from Taiwan," Pacific Economic Review, Wiley Blackwell, vol. 19(4), pages 483-501, October.
    11. Avi Dor & William Encinosa & Kathleen Carey, 2016. "Do Good Reports Mean Higher Prices? The Impact of Hospital Compare Ratings on Cardiac Pricing," NBER Working Papers 22858, National Bureau of Economic Research, Inc.
    12. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.

    More about this item

    Keywords

    Health insurance; Natural experiment; Birth outcomes;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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