Social health insurance vs. tax-financed health systems - evidence from the OECD, Vol. 1 of 1

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Social health insurance vs. tax-financed health systems - evidence from the OECD

Author:	Wagstaff, Adam;	Collection Title:	Policy Research working paper ; no. WPS 4821
Country:	East Asia and Pacific;	Date Stored:	2009/01/21
Document Date:	2009/01/01	Document Type:	Policy Research Working Paper
Language:	English	Major Sector:	Health and other social services
Rel. Proj ID:	4E-Health Financing & Delivery In E. Asia -- -- P091397;	Region:	East Asia and Pacific
Report Number:	WPS4821	Sub Sectors:	Health
SubTopics:	Health Monitoring & Evaluation; Health Systems Development & Reform; Health Economics & Finance	TF No/Name:	TF037238-EAST ASIA REGION - SOCIAL ASSESSMENT AND ANALYSIS
Volume No:	1 of 1

Summary: This paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spending, amenable mortality, and labor market outcomes. The paper uses regression-based generalizations of difference-in-differences and instrumental variables to address the possible endogeneity of a country's health system. It finds that adopting social health insurance in preference to tax financing increases per capita health spending by 3-4 percent, reduces the formal sector share of employment by 8-10 percent, and reduces total employment by as much as 6 percent. For the most part, social health insurance adoption has no significant impact on amenable mortality, but for one cause-breast cancer among women-social health insurance systems perform significantly worse, with 5-6 percent more potential years of life lost.


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