Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes

Wagstaff, Adam ; Moreno-Serra, Rodrigo

World Bank, Washington, DC

关键词: AGED;    APPENDICITIS;    ARI;    BREAST CANCER;    BRONCHITIS;   

DOI  :  10.1596/1813-9450-4371
RP-ID  :  WPS4371

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

The post-communist transition to socialhealth insurance in many of the Central and Eastern Europeanand Central Asian countries provides a unique opportunity totry to answer some of the unresolved issues in the debateover the relative merits of social health insurance andtax-financed health systems. This paper employs aregression-based generalization of thedifference-in-differences method and instrumental variableson panel data from 28 countries for the period 1990-2004.The authors find that, controlling for any concurrentprovider payment reforms, adoption of social healthinsurance increased national health spending and hospitalactivity rates, but did not lead to better health outcomes.The authors also find that adoption of social healthinsurance reduced employment in the economy as a whole andincreased unemployment, although it did not apparentlyincrease the size of the informal economy.