IDEAS home Printed from https://ideas.repec.org/p/hhs/bergec/2017_018.html
   My bibliography  Save this paper

Who Benefits From Free Health Insurance: Evidence from Mexico

Author

Listed:

Abstract

We present the first comprehensive evidence on the health impacts of the introduction and expansion of a large non-contributory health insurance program in Mexico, the Seguro Popular (SP). SP provided access to health services without co-pays to individuals with no Social Security protection. To identify the impacts of the program we use its staggered rollout across municipalities between 2002 and 2010. Our intent-to-treat estimates show that SP reduced infant mortality by 10% in poor municipalities. We are unable to detect program impacts on mortality for children ages 1-4, adults or elderly. The decline in infant mortality is driven by reductions in deaths due to perinatal conditions, congenital malformations, diarrhea and respiratory infections. Also in poor municipalities, the introduction of SP is associated with an immediate 7% increase in obstetric-related hospital admissions and with a 6% increase in hospital admissions due to diarrhea and respiratory infections among infants. The decline in infant mortality attributed to SP closes 84% of the gap in infant mortality rates between poor and rich Mexican municipalities.

Suggested Citation

  • Conti, Gabriella & Ginja, Rita, 2017. "Who Benefits From Free Health Insurance: Evidence from Mexico," Working Papers in Economics 18/17, University of Bergen, Department of Economics.
    • Handle: RePEc:hhs:bergec:2017_018
    as

    Download full text from publisher

    File URL: http://ekstern.filer.uib.no/svf/2017/Working%20paper%2018-17.pdf
    File Function: Full text
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Gabriella Conti & Rita Ginja, Renata Narita, 2017. "Non-Contributory Health Insurance and Household Labor Supply: Evidence from Mexico," Working Papers, Department of Economics 2017_17, University of São Paulo (FEA-USP).
    2. Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2009. "Consumption Responses to In-Kind Transfers: Evidence from the Introduction of the Food Stamp Program," American Economic Journal: Applied Economics, American Economic Association, vol. 1(4), pages 109-139, October.
    3. Mariano Bosch & Raymundo M. Campos-Vazquez, 2014. "The Trade-Offs of Welfare Policies in Labor Markets with Informal Jobs: The Case of the "Seguro Popular" Program in Mexico," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 71-99, November.
    4. 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.
    5. repec:idb:brikps:35838 is not listed on IDEAS
    6. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    7. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    8. Jonathan Gruber & Nathaniel Hendren & Robert M. Townsend, 2014. "The Great Equalizer: Health Care Access and Infant Mortality in Thailand," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 91-107, January.
    9. Manudeep Bhuller & Tarjei Havnes & Edwin Leuven & Magne Mogstad, 2013. "Broadband Internet: An Information Superhighway to Sex Crime?," Review of Economic Studies, Oxford University Press, vol. 80(4), pages 1237-1266.
    10. Rodrigo Barros, 2008. "Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico," Discussion Papers 09-002, Stanford Institute for Economic Policy Research.
    11. Azuara, Oliver & Marinescu, Ioana, 2013. "Informality and the expansion of social protection programs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 32(5), pages 938-950.
    12. Ties Boerma & Patrick Eozenou & David Evans & Tim Evans & Marie-Paule Kieny & Adam Wagstaff, 2014. "Monitoring Progress towards Universal Health Coverage at Country and Global Levels," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-8, September.
    13. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, Oxford University Press, vol. 127(3), pages 1057-1106.
    14. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    15. Daron Acemoglu & David H. Autor & David Lyle, 2004. "Women, War, and Wages: The Effect of Female Labor Supply on the Wage Structure at Midcentury," Journal of Political Economy, University of Chicago Press, vol. 112(3), pages 497-551, June.
    16. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    17. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, Oxford University Press, vol. 119(1), pages 249-275.
    18. 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.
    19. Spenkuch, Jörg L., 2012. "Moral hazard and selection among the poor: Evidence from a randomized experiment," Journal of Health Economics, Elsevier, vol. 31(1), pages 72-85.
    20. John Scott, 2006. "Seguro Popular: Incidence Analysis," Working papers DTE 367, CIDE, División de Economía.
    21. Douglas Almond & Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2011. "Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes," The Review of Economics and Statistics, MIT Press, vol. 93(2), pages 387-403, May.
    22. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    23. Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.
    24. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    25. Tobias Pfutze, 2015. "Does access to health insurance reduce the risk of miscarriages? Evidence from Mexico’s Seguro popular," Latin American Economic Review, Springer;Centro de Investigaciòn y Docencia Económica (CIDE), vol. 24(1), pages 1-10, December.
    26. Janet Currie & Maya Rossin‐Slater, 2015. "Early‐Life Origins of Life‐Cycle Well‐Being: Research and Policy Implications," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(1), pages 208-242, January.
    27. Adriana Camacho & Emily Conover, 2013. "Effects of Subsidized Health Insurance on Newborn Health in a Developing Country," Economic Development and Cultural Change, University of Chicago Press, vol. 61(3), pages 633-658.
    28. 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.
    29. Aquino, R. & De Oliveira, N.F. & Barreto, M.L., 2009. "Impact of the Family Health Program on infant mortality in brazilian municipalities," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 87-93.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Julia Schmieder, 2020. "Fertility as a Driver of Maternal Employment," Discussion Papers of DIW Berlin 1882, DIW Berlin, German Institute for Economic Research.
    2. Schmieder, Julia, 2021. "Fertility as a driver of maternal employment," Labour Economics, Elsevier, vol. 72(C).
    3. del Valle, Alejandro, 2021. "The effects of public health insurance in labor markets with informal jobs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 77(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    2. Mahé, Clotilde, 2020. "Publicly provided healthcare and migration," Economics & Human Biology, Elsevier, vol. 39(C).
    3. Sonia Bhalotra & Rudi Rocha & Rodrigo R. Soares, 2020. "Can Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," Working Papers 03, Instituto de Estudos para Políticas de Saúde.
    4. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    5. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    6. 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.
    7. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    8. Cesur, Resul & Gunes, Pinar Mine & Tekin, Erdal & Ulker, Aydogan, 2015. "The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Birth and Mortality Rates in Turkey," IZA Discussion Papers 9329, Institute of Labor Economics (IZA).
    9. del Valle, Alejandro, 2021. "The effects of public health insurance in labor markets with informal jobs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 77(C).
    10. 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.
    11. Emily Gustafsson-Wright & Gosia Popławska & Zlata Tanović & Jacques Gaag, 2018. "The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 221-276, September.
    12. Bernal, Noelia & Costa-Font, Joan & Ritter, Patricia, 2022. "The Effect of Health Insurance on Child Nutritional Outcomes. Evidence from a Regression Discontinuity Design in Peru," IZA Discussion Papers 15490, Institute of Labor Economics (IZA).
    13. Adrienne M. Lucas & Nicholas L. Wilson, 2018. "Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 358-382, Summer.
    14. Jacqueline Fiore, 2017. "The Impact of the Affordable Care Act's Medicaid Expansion on Medicaid Spending by Health Care Service Category," Working Papers 1706, Tulane University, Department of Economics, revised Mar 2018.
    15. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    16. Mark Duggan & Atul Gupta & Emilie Jackson, 2022. "The Impact of the Affordable Care Act: Evidence from California's Hospital Sector," American Economic Journal: Economic Policy, American Economic Association, vol. 14(1), pages 111-151, February.
    17. Gabriella Conti & Rita Ginja, Renata Narita, 2018. "The Value of Health Insurance: A Household Job Search Approach," Working Papers, Department of Economics 2018_18, University of São Paulo (FEA-USP).
    18. 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.
    19. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    20. Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.

    More about this item

    Keywords

    Health Insurance; Child Mortality; Health Care Utilization; Mexico;
    All these keywords.

    JEL classification:

    • H10 - Public Economics - - Structure and Scope of Government - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O18 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Urban, Rural, Regional, and Transportation Analysis; Housing; Infrastructure

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:bergec:2017_018. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/iouibno.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Kjell Erik Lommerud (email available below). General contact details of provider: https://edirc.repec.org/data/iouibno.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.