Interesting paper by Patrick O. Asuming on insurance for the poor in Ghana (January 2013). The results are encouraging regarding the effects of subsidies combined with education.
Many developing countries have recently instituted social health insurance schemes (SHIs) to ease financial barriers to utilization of healthcare services and help mitigate the effects of adverse health shocks. Although these SHIs offer generous terms and benefits, enrollment remains low especially among the poorest households who are the intended primary beneficiaries. This paper implements randomized interventions to (i) understand the reasons for low enrollment; (ii) estimate the effects of insurance coverage on utilization of healthcare, financial protection and health; and (iii) provide insights into intra-household allocation of health resources. My results show that imperfect information, and insurance premium and fees affect enrollment. The demand for insurance is price elastic in the sense that small subsidies generate substantial enrollment effects. I find that insurance coverage leads to increased utilization of healthcare services, reduced out-of-pocket payments among individuals with prior positive expenses and improvement in health outcomes. My results suggest strong complementarities between providing information and providing subsidies in utilization and health outcomes, an indication of the importance of the combined interventions for achieving changes in health-seeking behavior and outcomes. Finally, I find evidence of son preference in the allocation of health resources within households.
The paper, "Getting the Poor to Enroll in Health Insurance, and Its Effects on Their Health: Evidence from a Field Experiment in Ghana," is mostly about the demand. I will keep my eyes open for a supply-side analysis, specially in developing countries where institutions are usually weak. Again, the results of the paper are promising.
Do you know of successful market-based solutions for health-problems of the poor?
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