Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD

Wagstaff, Adam

dc.creator	Wagstaff, Adam
dc.date	2012-03-19T19:08:26Z
dc.date	2012-03-19T19:08:26Z
dc.date	2009-01-01
dc.date.accessioned	2023-02-17T21:07:43Z
dc.date.available	2023-02-17T21:07:43Z
dc.identifier	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20090121101737
dc.identifier	http://hdl.handle.net/10986/4018
dc.identifier.uri	http://localhost:8080/xmlui/handle/CUHPOERS/244988
dc.description	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.
dc.language	English
dc.relation	Policy Research working paper ; no. WPS 4821
dc.rights	CC BY 3.0 IGO
dc.rights	http://creativecommons.org/licenses/by/3.0/igo/
dc.rights	World Bank
dc.subject	AGE GROUPS
dc.subject	AGED
dc.subject	BREAST CANCER
dc.subject	CANCERS
dc.subject	CAPITA HEALTH SPENDING
dc.subject	CAPITATION
dc.subject	CAPITATION SYSTEM
dc.subject	CAUSES OF DEATH
dc.subject	CERVICAL CANCER
dc.subject	COLON CANCER
dc.subject	COMPARISONS OF HEALTH EXPENDITURE
dc.subject	COMPETITION BETWEEN HOSPITALS
dc.subject	DEATH RATE
dc.subject	DEATH RATES
dc.subject	DEATHS
dc.subject	DEMOCRACY
dc.subject	DEVELOPING COUNTRIES
dc.subject	DIABETES
dc.subject	DIAGNOSIS
dc.subject	DISEASES
dc.subject	EARLY DETECTION
dc.subject	EXPENDITURES
dc.subject	FEE-FOR-SERVICE
dc.subject	FEMALES
dc.subject	GLOBAL BUDGETS
dc.subject	HEALTH AUTHORITIES
dc.subject	HEALTH CARE
dc.subject	HEALTH CARE COSTS
dc.subject	HEALTH CARE COVERAGE
dc.subject	HEALTH CARE FINANCING
dc.subject	HEALTH CARE NEEDS
dc.subject	HEALTH CARE PROVIDERS
dc.subject	HEALTH CARE REFORM
dc.subject	HEALTH CARE SYSTEM
dc.subject	HEALTH CARE SYSTEMS
dc.subject	HEALTH CARE SYSTEMS IN TRANSITION
dc.subject	HEALTH CARE UTILIZATION
dc.subject	HEALTH DATA
dc.subject	HEALTH ECONOMICS
dc.subject	HEALTH EXPENDITURE
dc.subject	HEALTH EXPENDITURE PER CAPITA
dc.subject	HEALTH FINANCE
dc.subject	HEALTH FINANCING
dc.subject	HEALTH FINANCING SYSTEM
dc.subject	HEALTH IMPACTS
dc.subject	HEALTH INSURANCE
dc.subject	HEALTH INSURANCE COVERAGE
dc.subject	HEALTH INSURANCE FUNDS
dc.subject	HEALTH ORGANIZATION
dc.subject	HEALTH OUTCOMES
dc.subject	HEALTH PLANNING
dc.subject	HEALTH POLICY
dc.subject	HEALTH SECTOR
dc.subject	HEALTH SECTOR REFORM
dc.subject	HEALTH SERVICES
dc.subject	HEALTH SERVICES RESEARCH
dc.subject	HEALTH STATUS
dc.subject	HEALTH STATUS INDICATORS
dc.subject	HEALTH SYSTEM
dc.subject	HEALTH SYSTEMS
dc.subject	HEALTH SYSTEMS IN TRANSITION
dc.subject	HEART DISEASE
dc.subject	HOSPITAL
dc.subject	HOSPITALS
dc.subject	HUMAN DEVELOPMENT
dc.subject	ILLNESS
dc.subject	IMMUNIZATIONS
dc.subject	INCOME
dc.subject	INCOME COUNTRIES
dc.subject	INDIVIDUAL MEMBERS
dc.subject	INEQUITIES
dc.subject	INEQUITIES IN HEALTH CARE
dc.subject	INFLUENZA
dc.subject	INFORMAL SECTOR
dc.subject	INFORMAL SECTOR WORKERS
dc.subject	INPATIENT ADMISSIONS
dc.subject	INSURANCE MARKET
dc.subject	INSURANCE SCHEMES
dc.subject	INSURANCE SYSTEMS
dc.subject	INSURERS
dc.subject	INTEGRATION
dc.subject	INTERNATIONAL COMPARISONS
dc.subject	LABOR MARKET
dc.subject	LABOR MARKETS
dc.subject	LEVEL OF HEALTH SPENDING
dc.subject	LIFE EXPECTANCY
dc.subject	MALIGNANT NEOPLASMS
dc.subject	MARKET ECONOMY
dc.subject	MATERNAL DEATH
dc.subject	MEDICAL CARE
dc.subject	MORTALITY
dc.subject	NATIONAL HEALTH
dc.subject	NATIONAL HEALTH INSURANCE
dc.subject	NATIONAL HEALTH SPENDING
dc.subject	NUMBER OF PEOPLE
dc.subject	PATIENTS
dc.subject	PERSONAL HEALTH
dc.subject	PHYSICIANS
dc.subject	PNEUMONIA
dc.subject	POCKET PAYMENTS
dc.subject	POLICY RESEARCH
dc.subject	POLICY RESEARCH WORKING PAPER
dc.subject	POPULATION STUDIES
dc.subject	PREGNANCY
dc.subject	PREMATURE DEATH
dc.subject	PRIMARY CARE
dc.subject	PRIVATE INSURANCE
dc.subject	PRIVATE SECTOR
dc.subject	PROGRESS
dc.subject	PROVIDER PAYMENT
dc.subject	PROVISION OF HEALTH CARE
dc.subject	PROVISION OF SERVICES
dc.subject	PUBLIC HEALTH
dc.subject	PUBLIC HEALTH CARE
dc.subject	PUBLIC HEALTH PROGRAMS
dc.subject	PUBLIC HEALTH SYSTEM
dc.subject	PUBLIC HOSPITALS
dc.subject	PUBLIC SERVICES
dc.subject	PURCHASER-PROVIDER SPLIT
dc.subject	PURCHASING POWER
dc.subject	QUALITY CARE
dc.subject	QUALITY OF CARE
dc.subject	RESPECT
dc.subject	RISK ADJUSTMENT
dc.subject	SCREENING
dc.subject	SHARE OF HEALTH SPENDING
dc.subject	SICKNESS FUNDS
dc.subject	SOCIAL HEALTH INSURANCE
dc.subject	SOCIAL SECURITY
dc.subject	TREATMENT
dc.subject	TUBERCULOSIS
dc.subject	TUBERCULOSIS CONTROL
dc.subject	UNEMPLOYMENT
dc.subject	WAR
dc.subject	WORKERS
dc.subject	WORKING-AGE POPULATION
dc.subject	WORLD HEALTH ORGANIZATION
dc.title	Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
dc.type	Publications & Research :: Policy Research Working Paper
dc.coverage	East Asia and Pacific