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Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru

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  • Sven Neelsen
  • Owen O'Donnell

Abstract

Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax‐financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment‐based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest. The probability of getting formal health care when sick is increased by almost two fifths, but the likelihood of being unable to afford treatment is reduced by more than a quarter. Consistent with the shallow coverage offered, there is no impact on use of inpatient care. Neither is there any effect on average out‐of‐pocket health care expenditure, but medical spending is reduced by up to 25% in the top quarter of the distribution. Copyright © 2017 John Wiley & Sons, Ltd.

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  • Sven Neelsen & Owen O'Donnell, 2017. "Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 179-203, December.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:12:p:e179-e203
    DOI: 10.1002/hec.3492
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    Cited by:

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    2. DECANCQ Koen & OLIVERA Javier & SCHOKKAERT Erik, 2018. "Program evaluation and ethnic differences: the Pension 65 program in Peru," LISER Working Paper Series 2018-21, Luxembourg Institute of Socio-Economic Research (LISER).
    3. Miguel Ángel Carpio & Lucero Gómez & Pablo Lavado, 2021. "Does social health insurance spillover to student performance? Evidence from an RDD in Peru," Working Papers 178, Peruvian Economic Association.
    4. Henry, Edward & Cullinan, John, 2021. "Mental health spillovers from serious family illness: Doubly robust estimation using EQ-5D-5L population normative data," Social Science & Medicine, Elsevier, vol. 279(C).
    5. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.

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    JEL classification:

    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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