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The Abolition of User Fees and the Demand for Health Care: Re-Evaluating the Impact

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  • Steven F. Koch

    () (Department of Economics, University of Pretoria)

Abstract

The abolition of user fees in South Africa, a policy implemented in 1994 for children under the age of six and the elderly, as well as pregnant and nursing mothers, is examined via regression discontinuity. The analysis focuses on provider choice decisions for curative care treatment, but also examines potential externalities that could arise from the policy. As a result of the policy, curative care demand in the public sector is found to increase by approximately 7 percent; however, the demand for curative care in the private sector is found to decrease by nearly the same amount, suggesting that the policy led to provider choice substitution. The analysis further supports the hypothesis that the health of young children improved marginally.

Suggested Citation

  • Steven F. Koch, 2012. "The Abolition of User Fees and the Demand for Health Care: Re-Evaluating the Impact," Working Papers 201219, University of Pretoria, Department of Economics.
  • Handle: RePEc:pre:wpaper:201219
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    References listed on IDEAS

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    1. Klaus Deininger & Paul Mpuga, 2005. "Economic and Welfare Impact of the Abolition of Health User Fees: Evidence from Uganda," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 14(1), pages 55-91, March.
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    Cited by:

    1. Steven F. Koch & Jeffrey S. Racine, 2016. "Healthcare facility choice and user fee abolition: regression discontinuity in a multinomial choice setting," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 927-950, October.
    2. Chitalu M. Chama-Chiliba and Steven F. Koch, 2014. "Assessing regional variation in the effect of the removal of user fees on institutional deliveries in rural Zambia," Working Papers 427, Economic Research Southern Africa.

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    Keywords

    Free Health Care; Regression Discontinuity;

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