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

71 Pages Posted: 20 Apr 2016

See all articles by Adam Wagstaff

Adam Wagstaff

World Bank - Development Research Group (DECRG)

Rodrigo Moreno-Serra

University of York - Department of Economics & Centre for Health Economics

Date Written: October 1, 2007

Abstract

The post-communist transition to social health insurance in many of the Central and Eastern European and Central Asian countries provides a unique opportunity to try to answer some of the unresolved issues in the debate over the relative merits of social health insurance and tax-financed health systems. This paper employs a regression-based generalization of the difference-in-differences method and instrumental variables on panel data from 28 countries for the period 1990-2004. The authors find that, controlling for any concurrent provider payment reforms, adoption of social health insurance increased national health spending and hospital activity rates, but did not lead tobetter health outcomes. The authors also find that adoption of social health insurance reduced employment in the economy as a whole and increased unemployment, although it did not apparently increase the size of the informal economy.

Keywords: Health Monitoring & Evaluation, Health Systems Development & Reform, Population Policies, Health Economics & Finance, Disease Control & Prevention

Suggested Citation

Wagstaff, Adam and Moreno-Serra, Rodrigo, Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment: Impacts on Health Sector and Labor Market Outcomes (October 1, 2007). World Bank Policy Research Working Paper No. 4371. Available at SSRN: https://ssrn.com/abstract=1020839

Adam Wagstaff (Contact Author)

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

HOME PAGE: http://econ.worldbank.org/staff/awagstaff

Rodrigo Moreno-Serra

University of York - Department of Economics & Centre for Health Economics ( email )

York YO10 5DD
United Kingdom
+44 1904 321 411 (Phone)

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