The Right to Health and the Health Effects of Denials

52 Pages Posted: 4 Sep 2021 Last revised: 19 May 2022

See all articles by Sonia R. Bhalotra

Sonia R. Bhalotra

IZA Institute of Labor Economics

Manuel Fernández Sierra

Universidad de Los Andes; IZA

Abstract

We estimate the health costs of supply-side barriers to accessing medical care. The setting is Colombia, where citizens have a constitutional right to health care, but insurance companies that manage delivery impose restrictions on access. We use administrative data on judicial claims for health as a proxy for unmet demand. We validate this using the register recording all health service utilization, estimating that a one standard deviation increase in judicial claims is associated with pervasive decreases in utilization rates of between 0.25 and 0.71 standard deviations, including in medical consultations, procedures, hospitalizations and emergency care. These restrictions on access manifest in population health outcomes. We estimate that a one standard deviation increase in judicial claims increases the all-cause mortality rate by between 0.10 and 0.23 standard deviations. Increases in mortality are pervasive across causes, with the largest increase in deaths from certain cancers. They are also pervasive across the age and sex distribution but larger among individuals over the age of fifty and (weakly) among women and the low-income population.

Keywords: health care, health insurance, mortality, right-to-health, litigation, universal-health-coverage, Colombia

JEL Classification: I11, I13, I18, K4

Suggested Citation

Bhalotra, Sonia R. and Fernández Sierra, Manuel, The Right to Health and the Health Effects of Denials. IZA Discussion Paper No. 14685, Available at SSRN: https://ssrn.com/abstract=3917300

Sonia R. Bhalotra (Contact Author)

IZA Institute of Labor Economics ( email )

P.O. Box 7240
Bonn, D-53072
Germany

Manuel Fernández Sierra

Universidad de Los Andes ( email )

Carrera 1a No. 18A-10
Santafe de Bogota, AA4976
Colombia
+57 (1) 339 4949 Ext. 5025 (Phone)

HOME PAGE: http://https://sites.google.com/view/manuelfernandezsierra

IZA ( email )

P.O. Box 7240
Bonn, D-53072
Germany

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