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 A. Olken, Arianna Ornaghi, Sudarno Sumarto.

Format:

Book

Author/Creator:

Banerjee, Abhijit.

Contributor:

National Bureau of Economic Research.

Finkelstein, Amy.

Hanna, Rema.

Olken, Benjamin A.

Ornaghi, Arianna.

Sumarto, Sudarno.

Series:

Working Paper Series (National Bureau of Economic Research) no. w26204.

NBER working paper series no. w26204

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Other Title:

Challenges of Universal Health Insurance in Developing Countries

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2019.

Summary:

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 lower-cost 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.

Notes:

Print version record

August 2019.