Progressive Universalism? The Impact of Targeted Coverage on Healthcare Access and Expenditures in Peru

Tinbergen Institute 16-019/V

42 Pages Posted: 24 Mar 2016  

Sven Neelsen

Erasmus University Rotterdam (EUR)

Owen O'Donnell

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

Date Written: March 22, 2016

Abstract

Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to healthcare by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population’s change in healthcare utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest. The probability of getting formal healthcare when sick is increased by almost two fifths, while the likelihood of being unable to afford treatment is reduced by more than a quarter. Consistent with the shallow cover offered, there is no impact on use of inpatient care. Mean out-of-pocket (OOP) expenditure on healthcare is unaffected but spending is reduced by up to one quarter at some points of the distribution. Among healthcare users, medical spending is reduced across much of the distribution and in relative terms falls most at lower quantiles, which is consistent with limited nominal and effective coverage of expensive treatments.

Keywords: Health insurance, health financing, healthcare, Universal Coverage, Peru

JEL Classification: H42, H51, I18

Suggested Citation

Neelsen, Sven and O'Donnell, Owen, Progressive Universalism? The Impact of Targeted Coverage on Healthcare Access and Expenditures in Peru (March 22, 2016). Tinbergen Institute 16-019/V. Available at SSRN: https://ssrn.com/abstract=2753122 or http://dx.doi.org/10.2139/ssrn.2753122

Sven Neelsen (Contact Author)

Erasmus University Rotterdam (EUR) ( email )

Burgemeester Oudlaan 50
3000 DR Rotterdam, Zuid-Holland 3062PA
Netherlands

Owen O'Donnell

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

Register to save articles to
your library

Register

Paper statistics

Downloads
56
rank
344,324
Abstract Views
496
PlumX