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Welfare effects of health insurance in Mexico: The case of Seguro Popular de Salud

Author

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  • Rocío García-Díaz
  • Sandra G Sosa-Rubí
  • Edson Serván-Mori
  • Gustavo Nigenda

Abstract

This study contributes with original empirical evidence on the distributional and welfare effects of one of the most important health policies implemented by the Mexican government in the last decade, the Seguro Popular de Salud (SPS). We analyze the effect of SPS on households’ welfare using a decomposable index that considers insured and uninsured households’ response to out-of-pocket (OOP) payments using both social welfare weights and inequality aversion. The disaggregation of the welfare index allows us to explore the heterogeneity of the SPS impact on households’ welfare. We applied propensity score matching to reduce the self-selection bias of being SPS insured. Overall results suggest non-conclusive results of the impact of SPS on households’ welfare. When we disaggregated the welfare index by different sub-population groups, our results suggest that households’ beneficiaries of SPS with older adults or living in larger cities are better protected against OOP health care payments than their uninsured counterparts. However, no effect was found among SPS-insured households living in rural and smaller cities, which is a result that could be attributed to limited access to health resources in these regions. Scaling up health insurance coverage is a necessary but not sufficient condition to ensure the protection of SPS coverage against financial risks among the poor.

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  • Rocío García-Díaz & Sandra G Sosa-Rubí & Edson Serván-Mori & Gustavo Nigenda, 2018. "Welfare effects of health insurance in Mexico: The case of Seguro Popular de Salud," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-18, July.
  • Handle: RePEc:plo:pone00:0199876
    DOI: 10.1371/journal.pone.0199876
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    1. Diana De Graeve & Tom Van Ourti, 2003. "The Distributional Impact of Health Financing in Europe: A Review," The World Economy, Wiley Blackwell, vol. 26(10), pages 1459-1479, November.
    2. David Coady & Emmanuel Skoufias, 2004. "On the Targeting and Redistributive Efficiencies of Alternative Transfer Instruments," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 50(1), pages 11-27, March.
    3. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
    4. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    5. Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009. "Heterogeneous impact of the "Seguro Popular" program on the utilization of obstetrical services in Mexico, 2001-2006: A multinomial probit model with a discrete endogenous variable," Journal of Health Economics, Elsevier, vol. 28(1), pages 20-34, January.
    6. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    7. repec:pri:rpdevs:deaton_paxson_poverty_children_paper is not listed on IDEAS
    8. Guido Erreygers, 2013. "A Dual Atkinson Measure Of Socioeconomic Inequality Of Health," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 466-479, April.
    9. 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.
    10. Shaohua Chen & Martin Ravallion, 2004. "How Have the World's Poorest Fared since the Early 1980s?," The World Bank Research Observer, World Bank, vol. 19(2), pages 141-169.
    11. Adam Wagstaff, 2007. "Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 441-456, May.
    12. Angus Deaton & Christina Paxson, 1997. "Poverty Among Children And The Elderly In Developing Countries," Working Papers 992, Princeton University, School of Public and International Affairs, Center for Research on Child Wellbeing..
    13. Edson Servan-Mori & Leticia Avila-Burgos & Gustavo Nigenda & Rafael Lozano, 2016. "A Performance Analysis of Public Expenditure on Maternal Health in Mexico," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-14, April.
    14. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    15. Paul Makdissi & Quentin Wodon, 2007. "Poverty‐Reducing and Welfare‐Improving Marginal Public Price and Price Cap Reforms," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 9(4), pages 683-698, August.
    16. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    17. Susan W. Parker & Joseph Saenz & Rebeca Wong, 2018. "Health Insurance and the Aging: Evidence From the Seguro Popular Program in Mexico," Demography, Springer;Population Association of America (PAA), vol. 55(1), pages 361-386, February.
    18. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208, February.
    19. repec:pri:crcwel:wp98-09-deaton is not listed on IDEAS
    20. Makdissi, Paul & Wodon, Quentin, 2002. "Consumption dominance curves: testing for the impact of indirect tax reforms on poverty," Economics Letters, Elsevier, vol. 75(2), pages 227-235, April.
    21. Gary V. Engelhardt & Jonathan Gruber, 2004. "Social Security and the Evolution of Elderly Poverty," NBER Working Papers 10466, National Bureau of Economic Research, Inc.
    22. Editors The, 2007. "From the Editors," Basic Income Studies, De Gruyter, vol. 2(1), pages 1-5, June.
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