Evaluating and Pricing Health Insurance in Lower-Income Countries: A Field Experiment in India

Anup Malani (), Cynthia Kinnan, Gabriella Conti, Kosuke Imai, Morgen Miller (), Shailender Swaminathan (), Alessandra Voena () and Bartek Woda ()
Additional contact information
Anup Malani: University of Chicago
Kosuke Imai: Harvard University
Morgen Miller: University of Chicago
Shailender Swaminathan: Brown University
Alessandra Voena: Stanford University
Bartek Woda: Amazon

No 16861, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: Universal health coverage is a widely shared goal across lower-income countries. We conducted a large-scale, 4-year trial that randomized premiums and subsidies for India's first national, public hospital insurance program, RSBY. We find roughly 60% uptake even when consumers were charged premiums equal to the government's cost for insurance. We also find substantial adverse selection into insurance at positive prices. Insurance enrollment increases insurance utilization, partly due to spillovers from use of insurance by neighbors. However, many enrollees attempted to use insurance but failed, suggesting that learning is critical to the success of public insurance. We find very few statistically significant impacts of insurance access or enrollment on health. Because there is substantial willingness-to-pay for insurance, and given how distortionary it is to raise revenue in the Indian context, we calculate that our sample population should be charged a premium for RSBY between INR 500-1000 rather than a zero premium to maximize the marginal value of public funds.

Keywords: health insurance; adverse selection; spillovers; marginal value of public funds (search for similar items in EconPapers)
JEL-codes: D1 I13 (search for similar items in EconPapers)
Pages: 97 pages
Date: 2024-03
New Economics Papers: this item is included in nep-dcm, nep-exp and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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Related works:
Working Paper: Evaluating and Pricing Health Insurance in Lower-Income Countries: A Field Experiment in India (2024)
Working Paper: Evaluating and pricing health insurance in lower-income countries: A field experiment in India (2024)
Working Paper: Evaluating and Pricing Health Insurance in Lower-Income Countries: A Field Experiment in India (2024)
Working Paper: Evaluating and Pricing Health Insurance in Lower-income Countries: A Field Experiment in India (2024)
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