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Who Benefits From Free Health Insurance: Evidence from Mexico

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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.

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  • 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
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    4. Patrick Opoku Asuming & Hyuncheol Bryant Kim & Armand Sim, 2024. "Selection and behavioral responses of health insurance subsidies in the long run: Evidence from a field experiment in Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 992-1032, May.
    5. Bancalari, Antonella & Berlinski, Samuel & Buitrago, Giancarlo & García, María Fernanda & de la Mata, Dolores & Vera-Hernandez, Marcos, 2023. "Health inequalities in Latin American and the Caribbean: child, adolescent, reproductive, metabolic syndrome and mental health," LSE Research Online Documents on Economics 120559, London School of Economics and Political Science, LSE Library.
    6. Schmieder, Julia, 2021. "Fertility as a driver of maternal employment," Labour Economics, Elsevier, vol. 72(C).
    7. Jonah S. Goldberg, 2023. "What we measure when we measure the effects of user fees: a replication, reanalysis, and extension of Tanaka, 2014," Empirical Economics, Springer, vol. 65(4), pages 1981-2009, October.
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    9. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.
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    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

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