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The Impact of National Health Insurance on Birth Outcomes: A Natural Experiment in Taiwan

  • Shin-Yi Chou
  • Michael Grossman
  • Jin-Tan Liu

We estimate the impacts of the introduction of National Health Insurance (NHI) in Taiwan in March 1995 on the health of infants. Prior to NHI, government workers (the control group) possessed health insurance policies with comprehensive coverage for births and infant medical care services. Private sector industrial workers and farmers (the treatment groups) lacked this coverage. All households received coverage for the services just mentioned as of March 1995. Since stringent requirements for reporting births introduced in 1994 produced artificial upward trends in early infant deaths, we focus on postneonatal mortality (deaths from the 28th through the 364th day of life per thousand survivors of the first 27 days of life). We find that the introduction of NHI led to reductions in this rate for infants born in farm households but not for infants born in private sector households. For the former group, the rate fell by 0.5 deaths per thousand survivors or by 13 percent relative to the mean in the pre-NHI period of 4 deaths per thousand survivors. An especially large decline of 6 deaths per thousand survivors occurred for pre-term infants-- a 36 percent drop relative to the pre-NHI mean of 17 deaths per thousand survivors.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 16811.

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Date of creation: Feb 2011
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Publication status: published as Chou, Shin-Yi & Grossman, Michael & Liu, Jin-Tan, 2014. "The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan," Journal of Development Economics, Elsevier, vol. 111(C), pages 75-91.
Handle: RePEc:nbr:nberwo:16811
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  1. Jonathan Gruber, 1996. "Health Insurance for Poor Women and Children in the U.S.: Lessons from the Past Decade," NBER Working Papers 5831, National Bureau of Economic Research, Inc.
  2. Chiang, Tung-liang, 1997. "Taiwan's 1995 health care reform," Health Policy, Elsevier, vol. 39(3), pages 225-239, March.
  3. Chris Manning, 2000. "Labour Market Adjustment to Indonesia's Economic Crisis: Context, Trends and Implications," Bulletin of Indonesian Economic Studies, Taylor & Francis Journals, vol. 36(1), pages 105-136.
  4. Chou, Shin-Yi & Grossman, Michael & Liu, Jin-Tan, 2014. "The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan," Journal of Development Economics, Elsevier, vol. 111(C), pages 75-91.
  5. Shin-Yi Chou & Jin-Tan Liu & James K. Hammitt, 2004. "National Health Insurance and Technology Adoption: Evidence from Taiwan," Contemporary Economic Policy, Western Economic Association International, vol. 22(1), pages 26-38, 01.
  6. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
  7. Finkelstein, Amy, et al., 2011. "The Oregon Health Insurance Experiment: Evidence from the First Year," Working Paper Series rwp11-040, Harvard University, John F. Kennedy School of Government.
  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. Guido W. Imbens, 2004. "Nonparametric Estimation of Average Treatment Effects Under Exogeneity: A Review," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 4-29, February.
  10. Smith, J.P. & Thomas, D. & Frankenberg, E. & Beegle, K., 2000. "Wages, Employment and Economic Shocks: Evidence from Indonesia," Papers 00-07, RAND - Labor and Population Program.
  11. Newey, Whitney K & West, Kenneth D, 1987. "A Simple, Positive Semi-definite, Heteroskedasticity and Autocorrelation Consistent Covariance Matrix," Econometrica, Econometric Society, vol. 55(3), pages 703-08, May.
  12. Chou, Shin-Yi & Liu, Jin-Tan & Hammitt, James K., 2003. "National Health Insurance and precautionary saving: evidence from Taiwan," Journal of Public Economics, Elsevier, vol. 87(9-10), pages 1873-1894, September.
  13. Yuyu Chen & Ginger Zhe Jin, 2010. "Does Health Insurance Coverage Lead to Better Health and Educational Outcomes? Evidence from Rural China," NBER Working Papers 16417, National Bureau of Economic Research, Inc.
  14. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
  15. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
  16. Becker, Gary S & Lewis, H Gregg, 1973. "On the Interaction between the Quantity and Quality of Children," Journal of Political Economy, University of Chicago Press, vol. 81(2), pages S279-88, Part II, .
  17. Chou, Y. J. & Staiger, Douglas, 2001. "Health insurance and female labor supply in Taiwan," Journal of Health Economics, Elsevier, vol. 20(2), pages 187-211, March.
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