Abstract
In many countries large parts of the population do not have access to health insurance. Peru has made an effort to change this in the early 2000s. The institutional setup gives rise to the rare opportunity to study the effects of health insurance coverage exploiting a sharp regression discontinuity design. We find large effects on utilization that are most pronounced for the provision of curative care. Individuals seeing a doctor leads to increased awareness about health problems and generates a potentially desirable form of supplier-induced demand: they decide to pay themselves for services that are in short supply.
Highlights
In developing countries, a large number of individuals is not covered by health insurance (Banerjee et al, 2004; Banerjee and Duflo, 2007)
The public health insurance program “Seguro Integral de Salud” (SIS), whose effect we study in this paper, was introduced in 2001
While it is commonly believed that the effects of health insurance coverage are positive, opportunities to control for selection by exploiting natural experiments or by conducting field experiments are rare, and we still lack empirical evidence on its impact on health care utilization and out-of-pocket expenditures
Summary
A large number of individuals is not covered by health insurance (Banerjee et al, 2004; Banerjee and Duflo, 2007). Individuals are often used to relying on informal forms of risk-sharing instead. We would like to thank Juan Pichihua from the Peruvian Ministry of Economics and functionaries of SIS and MINSA for providing useful information and for their comments and suggestions. We would like to thank the co-editor, Craig Garthwaite, and three anonymous referees for their insightful comments and suggestions
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