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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.
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  16. Shin-Yi Chou & Michael Grossman & Jin-Tan Liu, 2011. "The Impact of National Health Insurance on Birth Outcomes: A Natural Experiment in Taiwan," NBER Working Papers 16811, National Bureau of Economic Research, Inc.
  17. 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.
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