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

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

Abstract

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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  • 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.
  • Handle: RePEc:nbr:nberwo:16811
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    Cited by:

    1. Rana Ejaz Ali Khan & Muhammad Ali Raza, 2016. "Utilization of prenatal-care in India: an evidence from IDHS," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 18(1), pages 175-201, October.
    2. 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.
    3. Hope Corman & Dhaval M. Dave & Nancy E. Reichman, 2017. "Evolution of the Infant Health Production Function," NBER Working Papers 24131, National Bureau of Economic Research, Inc.
    4. Avi Dor & William Encinosa & Kathleen Carey, 2016. "Do Good Reports Mean Higher Prices? The Impact of Hospital Compare Ratings on Cardiac Pricing," NBER Working Papers 22858, National Bureau of Economic Research, Inc.
    5. Shin-Yi Chou & Jin-Tan Liu & Michael Grossman & Ted Joyce, 2010. "Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan," American Economic Journal: Applied Economics, American Economic Association, vol. 2(1), pages 33-61, January.
    6. Meng-Wen Tsou & Jin-Tan Liu & Kuang-Hsien Wang, 2014. "Impact of Low Birth Weight Child on Maternal Labour Force Participation: Evidence from Taiwan," Pacific Economic Review, Wiley Blackwell, vol. 19(4), pages 483-501, October.
    7. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer & Vuthiphan Vongmongkol, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," CESifo Working Paper Series 4262, CESifo Group Munich.
    8. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    9. Emmanuelle Lavaine & Matthew Neidell, 2017. "Energy Production and Health Externalities: Evidence from Oil Refinery Strikes in France," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 447-477.
    10. repec:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0169-z is not listed on IDEAS
    11. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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