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Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico

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  • Rodrigo Barros

    () (Stanford University)

Abstract

In 2002 the Mexican government began a very large expansion of government-funded healthcare for the poor - specifically, people not employed in the formal sector. The program, Seguro Popular (SP), was rolled out sequentially across different areas in Mexico. This paper uses the variation in program intensity over time and space induced by the roll-out, comparing people in the informal sector (eligible for SP) to those in the formal sector (ineligible for SP), to measure the program's impacts. I find that the program substantially reduced out-of-pocket health expenditures of beneficiaries and caused them to shift from private to public providers. However, the program had a negligible effect on the health of beneficiaries, perhaps because the quality of care was low. The program also had no effect on labor force participation or earnings. One worry among policymakers is that Seguro Popular might induce workers to shift into the informal sector. I find no evidence of this effect. The low quality of care provided under SP, while reducing the welfare gains to beneficiaries, may have prevented the unintended consequence of encouraging movement into the informal sector.

Suggested Citation

  • Rodrigo Barros, 2008. "Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico," Discussion Papers 09-002, Stanford Institute for Economic Policy Research.
  • Handle: RePEc:sip:dpaper:09-002
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    1. repec:eee:pubeco:v:154:y:2017:i:c:p:122-136 is not listed on IDEAS
    2. Pfutze, Tobias, 2014. "The Effects of Mexico’s Seguro Popular Health Insurance on Infant Mortality: An Estimation with Selection on the Outcome Variable," World Development, Elsevier, vol. 59(C), pages 475-486.
    3. Alonso-Ortiz, Jorge & Leal Ordonez, Julio, 2013. "The Elasticity of Informality to Taxes and Transfers," MPRA Paper 49568, University Library of Munich, Germany.
    4. Spenkch, Jörg L., 2011. "Adverse selection and moral hazard among the poor: evidence from a randomized experiment," MPRA Paper 31443, University Library of Munich, Germany.
    5. Bernal Lobato, N., 2014. "Essays in applied microeconomics," Other publications TiSEM 9b638b3d-2f83-452a-b2c8-c, Tilburg University, School of Economics and Management.
    6. Lisa Bagnoli, 2017. "Does National Health Insurance Improve Children's Health ?National and Regional Evidence from Ghana," Working Papers ECARES ECARES 2017-03, ULB -- Universite Libre de Bruxelles.
    7. François Cohen & Antoine Dechezlepretre, 2017. "Mortality inequality, temperature and public health provision: evidence from Mexico," GRI Working Papers 268, Grantham Research Institute on Climate Change and the Environment.
    8. Raymundo M. Campos-Vázquez & Melissa A. Knox, 2013. "Social Protection Programs and Employment: The Case of Mexico's Seguro Popular Program," Economía Mexicana NUEVA ÉPOCA, , vol. 0(2), pages 403-448, July-Dece.
    9. Clarke, Damian & Mühlrad, Hanna, 2016. "The Impact of Abortion Legalization on Fertility and Maternal Mortality: New Evidence from Mexico," Working Papers in Economics 661, University of Gothenburg, Department of Economics.
    10. Tobias Pfutze, 2015. "Does access to health insurance reduce the risk of miscarriages? Evidence from Mexico’s Seguro popular," Latin American Economic Review, Springer;Centro de Investigaciòn y Docencia Económica (CIDE), vol. 24(1), pages 1-10, December.
    11. Ramos Francia Manuel & García-Verdú Santiago, 2017. "Bank Credit Allocation and Sectorial Concentration in Mexico: Some Empirical Evidence," Working Papers 2017-14, Banco de México.
    12. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.
    13. Spenkuch, Jörg L., 2012. "Moral hazard and selection among the poor: Evidence from a randomized experiment," Journal of Health Economics, Elsevier, vol. 31(1), pages 72-85.
    14. Angel-Urdinola, Diego F. & Haimovich, Francisco & Robayo, Monica, 2009. "Is Social Assistance Contributing to Higher Informality in Turkey?," MPRA Paper 27675, University Library of Munich, Germany.
    15. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.

    More about this item

    Keywords

    Mexico; healthcare; Seguro Popular; welfare;

    JEL classification:

    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • O17 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Formal and Informal Sectors; Shadow Economy; Institutional Arrangements

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