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Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes

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  • Wagstaff, Adam
  • Moreno-Serra, Rodrigo

Abstract

The post-Communist transition to social health insurance in many of the Central and Eastern European and Central Asian countries provides a unique opportunity to try to answer some of the unresolved issues in the debate over the relative merits of social health insurance and tax-financed health systems. This paper employs regression-based generalizations of the difference-in-differences method on panel data from 28 countries for the period 1990-2004. We find that, controlling for any concurrent provider payment reforms, adoption of social health insurance increased national health spending and hospital activity rates, but did not lead to better health outcomes.

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  • Wagstaff, Adam & Moreno-Serra, Rodrigo, 2009. "Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes," Journal of Health Economics, Elsevier, vol. 28(2), pages 322-340, March.
  • Handle: RePEc:eee:jhecon:v:28:y:2009:i:2:p:322-340
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    Cited by:

    1. He, Huajing & Nolen, Patrick J., 2019. "The effect of health insurance reform: Evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 168-179.
    2. Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
    3. Wagstaff, Adam, 2009. "Social health insurance vs. tax-financed health systems - evidence from the OECD," Policy Research Working Paper Series 4821, The World Bank.
    4. Connolly, Sheelah & Wren, Maev-Ann, 2016. "The 2011 proposal for Universal Health Insurance in Ireland: Potential implications for healthcare expenditure," Health Policy, Elsevier, vol. 120(7), pages 790-796.
    5. Reibling, Nadine & Ariaans, Mareike & Wendt, Claus, 2019. "Worlds of Healthcare: A Healthcare System Typology of OECD Countries," Health Policy, Elsevier, vol. 123(7), pages 611-620.
    6. Gordeev, Vladimir S. & Pavlova, Milena & Groot, Wim, 2011. "Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector," Health Policy, Elsevier, vol. 102(2), pages 270-277.
    7. Yanwen Wang & Song Hong & Yifei Wang & Xi Gong & Chao He & Zhendong Lu & F. Benjamin Zhan, 2019. "What is the difference in global research on Central Asia before and after the collapse of the USSR: a bibliometric analysis," Scientometrics, Springer;Akadémiai Kiadó, vol. 119(2), pages 909-930, May.
    8. Obrizan, Maksym, 2019. "Diverging trends in health care use between 2010 and 2016: Evidence from three groups of transition countries," Economic Systems, Elsevier, vol. 43(1), pages 19-29.
    9. Israel Marques, 2014. "Firms And Social Policy In The Post-Communist Bloc: Evidence From Russia," HSE Working papers WP BRP 87/EC/2014, National Research University Higher School of Economics.
    10. Moheddine Younsi & Mohamed Chakroun & Amine Nafla, 2016. "Robust analysis of the determinants of healthcare expenditure growth: evidence from panel data for low-, middle- and high-income countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(4), pages 580-601, October.
    11. Wren, Maev-Ann & FitzPatrick, Aoife, 2020. "How does Irish healthcare expenditure compare internationally?," Research Series, Economic and Social Research Institute (ESRI), number RS114, November.
    12. Salaheddine El Omari & Mahmoud Karasneh, 2021. "Social health insurance in the Philippines: do the poor really benefit?," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 45(1), pages 171-187, January.
    13. Owen Smith & Son Nam Nguyen, 2013. "Getting Better : Improving Health System Outcomes in Europe and Central Asia," World Bank Publications, The World Bank, number 13832, November.
    14. Obrizan, Maksym, 2017. "Does EU membership prevent crowding out of public health care? Evidence from 28 transition countries," MPRA Paper 81708, University Library of Munich, Germany.
    15. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2010. "System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia," Journal of Health Economics, Elsevier, vol. 29(4), pages 585-602, July.
    16. Mark D Huffman & Krishna D Rao & Andres Pichon-Riviere & Dong Zhao & S Harikrishnan & Kaushik Ramaiya & V S Ajay & Shifalika Goenka & Juan I Calcagno & Joaquín E Caporale & Shaoli Niu & Yan Li & Jing , 2011. "A Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-10, June.
    17. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press, vol. 32(1), pages 147-189.
    18. Enami, Ali, 2016. "Determinants of Child Mortality in Africa: A Methodological Discussion," MPRA Paper 68671, University Library of Munich, Germany.
    19. Le, Nga T.Q. & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2017. "Effects of health insurance on labour supply: Evidence from the health care fund for the poor in Viet Nam," MERIT Working Papers 2017-050, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    20. Marques II, Israel, 2018. "Firms and social policy preferences under weak institutions : Evidence from Russia," BOFIT Discussion Papers 7/2018, Bank of Finland, Institute for Economies in Transition.
    21. Achelrod, Dmitrij & Welte, Tobias & Schreyögg, Jonas & Stargardt, Tom, 2016. "Costs and outcomes of the German disease management programme (DMP) for chronic obstructive pulmonary disease (COPD)—A large population-based cohort study," Health Policy, Elsevier, vol. 120(9), pages 1029-1039.

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