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Is there an ex-ante moral hazard on Indonesia’s health insurance? An impact analysis on household waste management behavior

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  • Beta Yulianita Gitaharie
  • Rus’an Nasrudin
  • Ayu Putu Arantza Bonita
  • Lovina Aisha Malika Putri
  • Muhammad Abdul Rohman
  • Dwini Handayani

Abstract

The presence of ex-ante moral hazard could undermine the potential gain from expanding health insurance coverage in developing nations. To test the proposition, this study utilizes a nationally representative longitudinal survey with Indonesia’s health insurance for poor policy in 2014 as the quasi-experimental case study. The country represents developing nations that undergo a massive and rapid expansion of health insurance coverage. The empirical approach combines a matching and difference-in-differences method to obviate potential bias of the selectivity nature of health insurance provision and time-invariant unobserved factors. The findings suggest the presence of ex-ante moral hazard in the form of the less people using trash cans associated with the introduction of the subsidized health insurance premium. The results add empirical findings of a negative side effect of expanding health insurance coverage in developing nations.

Suggested Citation

  • Beta Yulianita Gitaharie & Rus’an Nasrudin & Ayu Putu Arantza Bonita & Lovina Aisha Malika Putri & Muhammad Abdul Rohman & Dwini Handayani, 2022. "Is there an ex-ante moral hazard on Indonesia’s health insurance? An impact analysis on household waste management behavior," PLOS ONE, Public Library of Science, vol. 17(12), pages 1-21, December.
    • Handle: RePEc:plo:pone00:0276521
    DOI: 10.1371/journal.pone.0276521
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    References listed on IDEAS

    as
    1. Vivi Alatas & Abhijit Banerjee & Rema Hanna & Benjamin A. Olken & Julia Tobias, 2012. "Targeting the Poor: Evidence from a Field Experiment in Indonesia," American Economic Review, American Economic Association, vol. 102(4), pages 1206-1240, June.
    2. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
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    5. Ranjan Shrestha, 2021. "Health Insurance for the Poor, Healthcare Use and Health Outcomes in Indonesia," Bulletin of Indonesian Economic Studies, Taylor & Francis Journals, vol. 57(1), pages 85-110, January.
    6. Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2018. "Effects of the Affordable Care Act on Health Behaviors after Three Years," IZA Discussion Papers 11468, Institute of Labor Economics (IZA).
    7. Jonathan Klick & Thomas Stratmann, 2007. "Diabetes Treatments and Moral Hazard," Journal of Law and Economics, University of Chicago Press, vol. 50(3), pages 519-538.
    8. 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.
    9. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
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    11. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    12. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
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