A Politically Robust Experimental Design for Public Policy Evaluation, With Application to the Mexican Universal Health Insurance Program

Journal of Policy Analysis and Management, Vol. 26, No. 3, pp. 479-506, 2007

31 Pages Posted: 18 Sep 2007 Last revised: 27 Jul 2008

See all articles by Gary King

Gary King

Harvard University

Emmanuela Gakidou

University of Washington - Institute for Health Metrics and Evaluation

Nirmala Ravishankar

Harvard University

Ryan T. Moore

Washington University in St. Louis - Department of Political Science

Jason Lakin

Harvard University

Manett Vargas

Harvard University

Martha Maria Tellez-Rojo

National Institute of Public Health (Mexico)

Juan Eugenio Hernandez Avila

National Institute of Public Health (Mexico)

Mauricio Hernandez Avila

Ministry of Health Mexico

Hector Hernandez Llama

Consultant

Abstract

We develop an approach to conducting large scale randomized public policy experiments intended to be more robust to the political interventions that have ruined some or all parts of many similar previous efforts. Our proposed design is insulated from selection bias in some circumstances even if we lose observations; our inferences can still be unbiased even if politics disrupts any two of the three steps in our analytical procedures; and other empirical checks are available to validate the overall design. We illustrate with a design and empirical validation of an evaluation of the Mexican Seguro Popular de Salud (Universal Health Insurance) program we are conducting. Seguro Popular, which is intended to grow to provide medical care, drugs, preventative services, and financial health protection to the 50 million Mexicans without health insurance, is one of the largest health reforms of any country in the last two decades. The evaluation is also large scale, constituting one of the largest policy experiments to date and what may be the largest randomized health policy experiment ever.

Suggested Citation

King, Gary and Gakidou, Emmanuela and Ravishankar, Nirmala and Moore, Ryan T. and Lakin, Jason and Vargas, Manett and Tellez-Rojo, Martha Maria and Avila, Juan Eugenio Hernandez and Hernandez Avila, Mauricio and Hernandez Llama, Hector, A Politically Robust Experimental Design for Public Policy Evaluation, With Application to the Mexican Universal Health Insurance Program. Journal of Policy Analysis and Management, Vol. 26, No. 3, pp. 479-506, 2007, Available at SSRN: https://ssrn.com/abstract=1013359

Gary King (Contact Author)

Harvard University ( email )

1737 Cambridge St.
Institute for Quantitative Social Science
Cambridge, MA 02138
United States
617-500-7570 (Phone)

HOME PAGE: http://gking.harvard.edu

Emmanuela Gakidou

University of Washington - Institute for Health Metrics and Evaluation ( email )

146 N. Canal St.
Seattle, WA 98103
United States

Nirmala Ravishankar

Harvard University ( email )

1875 Cambridge Street
Cambridge, MA 02138
United States

Ryan T. Moore

Washington University in St. Louis - Department of Political Science ( email )

Campus Box 1133
One Brookings Drive
Saint Louis, MO 63130-4899
United States

HOME PAGE: http://rtm.wustl.edu/

Jason Lakin

Harvard University

1875 Cambridge Street
Cambridge, MA 02138
United States

Manett Vargas

Harvard University

1875 Cambridge Street
Cambridge, MA 02138
United States

Martha Maria Tellez-Rojo

National Institute of Public Health (Mexico)

Universidad 655
Santa María Ahuacatitlán
Cuernavaca Morelos
Mexico

Juan Eugenio Hernandez Avila

National Institute of Public Health (Mexico)

Universidad 655
Santa María Ahuacatitlán
Cuernavaca Morelos
Mexico

Mauricio Hernandez Avila

Ministry of Health Mexico

Mexico

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