The Challenges of Universal Health Insurance in Developing Countries: Experimental Evidence from Indonesia's National Health Insurance

• 成果类型: Article
• 署名作者: Banerjee, Abhijit; Finkelstein, Amy; Hanna, Rema; Olken, Benjamin A.; Ornaghi, Arianna; Sumarto, Sudarno
• 署名单位: Massachusetts Institute of Technology (MIT); Harvard University; University of Warwick
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20200523
• 发表日期: 2021
• 页码: 3035-3063
• 关键词: Adverse selection; social-security; QUALITY; MARKETS

摘要

To investigate barriers to universal health insurance in developing countries, we designed a randomized experiment involving about 6,000 households in Indonesia who are subject to a government health insurance program with a weakly enforced mandate. Time-limited subsidies increased enrollment and attracted lower-cost enrollees, in part by reducing the strategic timing of enrollment to correspond with health needs. Registration assistance also increased enrollment, but increased attempted enrollment much more, as over one-half of households who attempted to enroll did not successfully do so. These findings underscore how weak administrative capacity can create important challenges in developing countries for achieving widespread coverage.