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The effects of access to health insurance: Evidence from a regression discontinuity design in Peru

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  • Bernal, Noelia
  • Carpio, Miguel A.
  • Klein, Tobias J.

Abstract

In many countries large parts of the population do not have access to health insurance. Peru has made an effort to change this in the early 2000s. The institutional setup gives rise to the rare opportunity to study the effects of health insurance coverage exploiting a sharp regression discontinuity design. We find large effects on utilization that are most pronounced for the provision of curative care. Individuals seeing a doctor leads to increased awareness about health problems and generates a potentially desirable form of supplier-induced demand: they decide to pay themselves for services that are in short supply.

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  • Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.
  • Handle: RePEc:eee:pubeco:v:154:y:2017:i:c:p:122-136
    DOI: 10.1016/j.jpubeco.2017.08.008
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    3. Guerrero, Natalia & Molina, Oswaldo & Winkelried, Diego, 2018. "Conditional cash transfers, spillovers and informal health care: Evidence from Peru," MPRA Paper 88586, University Library of Munich, Germany.
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    7. Yu-Chin Hsu & Chung-Ming Kuan & Giorgio Teng-Yu Lo, 2017. "Quantile Treatment Effects in Regression Discontinuity Designs with Covariates," IEAS Working Paper : academic research 17-A009, Institute of Economics, Academia Sinica, Taipei, Taiwan.
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    18. Limwattananon, Supon & Neelsen, Sven & O'Donnell, Owen & Prakongsai, Phusit & Tangcharoensathien, Viroj & van Doorslaer, Eddy & Vongmongkol, Vuthiphan, 2015. "Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand," Journal of Public Economics, Elsevier, vol. 121(C), pages 79-94.

    More about this item

    Keywords

    Public health insurance; Informal sector; Health care utilization; Regression discontinuity design; Supplier-induced demand;

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O17 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Formal and Informal Sectors; Shadow Economy; Institutional Arrangements

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