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Informal Groups and Health Insurance Take-up Evidence from a Field Experiment

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  • Chemin, Matthieu

Abstract

This paper presents the results of 20 randomized experiments aimed at understanding the low take-up of in-patient health insurance observed in developing countries. Take-up does not increase when participants receive information about the product, or an assistance to register, or small subsidies of 2, 10, or 30%. Take-up does not increase when the same information is provided by local respected community leaders, when participants are offered an in-kind gift (a chicken) if they register, when participants are offered the possibility to contribute lower and more frequent payments, or the possibility to pay by cellphone. A full subsidy generates a mere 45% take-up (with no retention after one year). In contrast to these low take-up rates, presenting the same information without any subsidies to existing informal groups raises take-up to 12% (still 7% after one year), as well as trust and knowledge of the product. Social networks play a major role in the adoption of health insurance. This paper provides a cost-effective way to increase take-up of health insurance, while subsidies are found to be largely ineffective at raising take-up in the long run.

Suggested Citation

  • Chemin, Matthieu, 2018. "Informal Groups and Health Insurance Take-up Evidence from a Field Experiment," World Development, Elsevier, vol. 101(C), pages 54-72.
  • Handle: RePEc:eee:wdevel:v:101:y:2018:i:c:p:54-72
    DOI: 10.1016/j.worlddev.2017.08.001
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    Cited by:

    1. Aurélien Baillon & Aleli Kraft & Owen O'Donnell & Kim van Wilgenburg, 2019. "A behavioral decomposition of willingness to pay for health insurance," Tinbergen Institute Discussion Papers 19-077/I, Tinbergen Institute.
    2. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2019. "Can information increase the understanding and uptake of insurance? Lessons from a randomized experiment in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 220(C), pages 102-111.

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    Keywords

    health insurance; informal groups;

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