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Social health insurance vs. tax-financed health systems - evidence from the OECD, Volume 1
Author:Wagstaff, Adam; Country:East Asia and Pacific;
Date Stored:2009/01/21Document Date:2009/01/01
Document Type:Policy Research Working PaperSubTopics:Health Monitoring & Evaluation; Health Systems Development & Reform; Health Economics & Finance
Language:EnglishMajor Sector:Health and other social services
Rel. Proj ID:4E-Health Financing & Delivery In E. Asia -- -- P091397;Region:East Asia and Pacific
Report Number:WPS4821Sub Sectors:Health
Collection Title:Policy Research working paper ; no. WPS 4821TF No/Name:TF037238-EAST ASIA REGION - SOCIAL ASSESSMENT AND ANALYSIS
Volume No: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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