Publication: Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
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2009-01-01
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2012-03-19
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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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“Wagstaff, Adam. 2009. Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD. Policy Research working paper ; no. WPS 4821. © World Bank. http://hdl.handle.net/10986/4018 License: CC BY 3.0 IGO.”
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