The challenges of universal health insurance in developing countries: Evidence from a large-scale randomized experiment in Indonesia

Abhijit Banerjee, Amy Finkelstein, Rema Hanna, Benjamin Olken, Arianna Ornaghi and Sudarno Sumarto ()
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Amy Finkelstein: MIT
Rema Hanna: Harvard University
Arianna Ornaghi: University of Warwick Sudarno Sumarto, TNP2K and SMERU

The Warwick Economics Research Paper Series (TWERPS) from University of Warwick, Department of Economics

Abstract: To assess ways to achieve widespread health insurance coverage with financial solvency in developing countries, we designed a randomized experiment involving almost 6,000 households in Indonesia who are subject to a nationally mandated government health insurance program. We assessed several interventions that simple theory and prior evidence suggest could increase coverage and reduce adverse selection: substantial temporary price subsidies (which had to be activated within a limited time window and lasted for only a year), assisted registration, and information. Both temporary subsidies and assisted registration increased initial enrollment. Temporary subsidies attracted lowercost enrollees, in part by eliminating the practice observed in the no subsidy group of strategically timing coverage for a few months during health emergencies. As a result, while subsidies were in effect, they increased coverage more than eightfold, at no higher unit cost; even after the subsidies ended, coverage remained twice as high, again at no higher unit cost. However, the most intensive (and effective) intervention – assisted registration and a full one-year subsidy – resulted in only a 30 percent initial enrollment rate, underscoring the challenges to achieving widespread coverage.

Date: 2020
New Economics Papers: this item is included in nep-dev, nep-exp, nep-hea, nep-ias and nep-sea
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https://warwick.ac.uk/fac/soc/economics/research/w ... p_1241_-_ornaghi.pdf

Related works:
Working Paper: The Challenges of Universal Health Insurance in Developing Countries: Evidence from a Large-scale Randomized Experiment in Indonesia (2019)
Working Paper: The Challenges of Universal Health Insurance in Developing Countries: Evidence from a Large-scale Randomized Experiment in Indonesia (2019)
Working Paper: The Challenges of Universal Health Insurance in Developing Countries: Evidence from a Large-scale Randomized Experiment in Indonesia
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Persistent link: https://EconPapers.repec.org/RePEc:wrk:warwec:1241

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