The Incidence of Health Shocks, Formal Health Insurance, and Informal Coping Mechanisms

Abstract

In recent years, both theoretical and empirical research has accumulated in development economics literature regarding household behavior in response to shocks in developing countries. The literature especially has explored deeply the impact of weather-related shocks—such as droughts and floods—and the efficiency of informal mechanisms to cope with these shocks. In sharp contrast, our knowledge on the economics of health shocks in low-income developing countries is rather limited. A few studies have documented that low incomes and poor health insurance coverage account for catastrophic medical expenditures in the event of a health shock. This study uses a combination of Ghanaian household survey datasets to examine the different coping mechanisms employed by uninsured households to protect themselves from the incidence of health shocks. In addition, it explores the impact of formal health insurance (the National Health Insurance Scheme) on households’ out-of-pocket spending and catastrophic health expenditures.