Mainstreaming health insurance for people with disabilities

Many low- and middle-income countries have introduced public health insurance schemes to increase access to health care and provide financial protection against the costs of care for disadvantaged groups. Using national health household survey data from Vietnam and an appropriate two-part model, this paper examines the targeting effectiveness of public health insurance schemes and their impact on health care utilization for persons with disabilities. Results suggest that current community-based targeting methods are not effective, and that insurance mechanisms are an unsatisfactory buffer for inpatient-related costs to which persons with disabilities are prone. A higher level of disability targeting is recommended, both in terms of eligibility and benefits.

[1]  J. Angrist,et al.  Digitized by the Internet Archive in 2011 with Funding from Estimation of Limited-dependent Variable Models with Dummy Endogenous Regressors: Simple Strategies for Empirical Practice , 2011 .

[2]  Sophie Mitra.  Disability and Social Safety Nets in Developing Countries , 2005 .

[3]  L. Gilson,et al.  Ensuring Equal Access to Health Services: User Fee Systems and the Poor , 2000 .

[4]  Disability Cash Transfers in the Context of Poverty and Unemployment: The Case of South Africa , 2010 .

[5]  C. Propper,et al.  Income-related inequalities in health: some international comparisons. , 1997, Journal of health economics.

[6]  P. Berman,et al.  Household utilization and expenditure on private and public health services in Vietnam. , 2002, Health policy and planning.

[7]  T. Shakespeare,et al.  Defending the Social Model , 1997 .

[8]  Sophie Mitra,et al.  Disability and Poverty in Developing Countries: A Snapshot from the World Health Survey , 2011 .

[9]  W. Manning,et al.  Estimating Log Models: To Transform or Not to Transform? , 1999, Journal of health economics.

[10]  A. Deaton.  The Analysis of Household Surveys : A Microeconometric Approach to Development Policy , 1997 .

[11]  S. Witter.  'Doi moi' and health: the effect of economic reforms on the health system in Vietnam. , 1996, The International journal of health planning and management.

[12]  B. Wolfe,et al.  The economics of disability and disability policy , 2000 .

[13]  C. Morris,et al.  A Comparison of Alternative Models for the Demand for Medical Care , 1983 .

[14]  C. Ai,et al.  Interaction terms in logit and probit models , 2003 .

[15]  Andrew M. Jones.  Chapter 6 – Health Econometrics* , 2000 .

[16]  Christopher F. Baum,et al.  Instrumental Variables and GMM: Estimation and Testing , 2003 .

[17]  J. Conning,et al.  Social Protection Discussion Paper Series Community Based Targeting Mechanisms for Social Safety Nets , 2002 .

[18]  Magnus Lindelow,et al.  Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation , 2007 .

[19]  W. Manning,et al.  The logged dependent variable, heteroscedasticity, and the retransformation problem. , 1998, Journal of health economics.

[20]  H. Berry,et al.  Disability measures as an indicator of poverty: A case study from Viet Nam , 2012 .

[21]  H. Berry,et al.  Health care utilization, cost burden and coping strategies by disability status: an analysis of the Viet Nam National Health Survey. , 2011, The International journal of health planning and management.

[22]  Sudeshna Mitra,et al.  Disability and the Rural Labor Market in India: Evidence for Males in Tamil Nadu , 2008 .

[23]  U. Gerdtham,et al.  International Journal for Equity in Health Health Financing for the Poor Produces Promising Short-term Effects on Utilization and Out-of-pocket Expenditure: Evidence from Vietnam , 2009 .

[24]  W. Manning,et al.  Moral Hazard and Consumer Incentives in Health Care , 2000 .

[25]  J. Angrist,et al.  Estimation of Limited Dependent Variable Models With Dummy Endogenous Regressors , 2001 .

[26]  D Y Lin,et al.  Methods for analyzing health care utilization and costs. , 1999, Annual review of public health.

[27]  Stanislav Kolenikov,et al.  Resampling Variance Estimation for Complex Survey Data , 2010 .

[28]  T. Carney,et al.  Social Security In Australia , 1994 .

[29]  M. Perlman,et al.  Health, Economics, and Health Economics , 1983 .

[30]  P. Martinsson,et al.  Health insurance and treatment seeking behaviour: evidence from a low-income country. , 2004, Health economics.

[31]  B. Wolfe.  Measuring disability and health. , 1984, Journal of health economics.

[32]  B. Ekman,et al.  Health insurance reform in Vietnam: a review of recent developments and future challenges. , 2008, Health policy and planning.

[33]  T. Ensor,et al.  Access and payment for health care: the poor of Northern Vietnam. , 1996, The International journal of health planning and management.

[34]  H. Lucas,et al.  Economic transition should come with a health warning: the case of Vietnam , 2002, Journal of epidemiology and community health.

[35]  Melinda Beeuwkes Buntin,et al.  Too much ado about two-part models and transformation? Comparing methods of modeling Medicare expenditures. , 2004, Journal of health economics.

[36]  M. Palmer,et al.  Models and measurement in disability: an international review. , 2012, Health policy and planning.

[37]  R. Bitrán.  Waivers and exemptions for health services in developing countries , 2002 .

[38]  M. Palmer.  Disability and Poverty: A Conceptual Review , 2011 .

[39]  C. Ai,et al.  Computing Interaction Effects and Standard Errors in Logit and Probit Models , 2004 .