Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD

This paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spendin...

Full description

Bibliographic Details
Main Author: Wagstaff, Adam
Format: Policy Research Working Paper
Language:English
Published: 2012
Subjects:
WAR
Online Access:http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20090121101737
http://hdl.handle.net/10986/4018
id okr-10986-4018
recordtype oai_dc
spelling okr-10986-40182021-04-23T14:02:14Z Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD Wagstaff, Adam AGE GROUPS AGED BREAST CANCER CANCERS CAPITA HEALTH SPENDING CAPITATION CAPITATION SYSTEM CAUSES OF DEATH CERVICAL CANCER COLON CANCER COMPARISONS OF HEALTH EXPENDITURE COMPETITION BETWEEN HOSPITALS DEATH RATE DEATH RATES DEATHS DEMOCRACY DEVELOPING COUNTRIES DIABETES DIAGNOSIS DISEASES EARLY DETECTION EXPENDITURES FEE-FOR-SERVICE FEMALES GLOBAL BUDGETS HEALTH AUTHORITIES HEALTH CARE HEALTH CARE COSTS HEALTH CARE COVERAGE HEALTH CARE FINANCING HEALTH CARE NEEDS HEALTH CARE PROVIDERS HEALTH CARE REFORM HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH CARE SYSTEMS IN TRANSITION HEALTH CARE UTILIZATION HEALTH DATA HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH FINANCE HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH IMPACTS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE FUNDS HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANNING HEALTH POLICY HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICES HEALTH SERVICES RESEARCH HEALTH STATUS HEALTH STATUS INDICATORS HEALTH SYSTEM HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEART DISEASE HOSPITAL HOSPITALS HUMAN DEVELOPMENT ILLNESS IMMUNIZATIONS INCOME INCOME COUNTRIES INDIVIDUAL MEMBERS INEQUITIES INEQUITIES IN HEALTH CARE INFLUENZA INFORMAL SECTOR INFORMAL SECTOR WORKERS INPATIENT ADMISSIONS INSURANCE MARKET INSURANCE SCHEMES INSURANCE SYSTEMS INSURERS INTEGRATION INTERNATIONAL COMPARISONS LABOR MARKET LABOR MARKETS LEVEL OF HEALTH SPENDING LIFE EXPECTANCY MALIGNANT NEOPLASMS MARKET ECONOMY MATERNAL DEATH MEDICAL CARE MORTALITY NATIONAL HEALTH NATIONAL HEALTH INSURANCE NATIONAL HEALTH SPENDING NUMBER OF PEOPLE PATIENTS PERSONAL HEALTH PHYSICIANS PNEUMONIA POCKET PAYMENTS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POPULATION STUDIES PREGNANCY PREMATURE DEATH PRIMARY CARE PRIVATE INSURANCE PRIVATE SECTOR PROGRESS PROVIDER PAYMENT PROVISION OF HEALTH CARE PROVISION OF SERVICES PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH PROGRAMS PUBLIC HEALTH SYSTEM PUBLIC HOSPITALS PUBLIC SERVICES PURCHASER-PROVIDER SPLIT PURCHASING POWER QUALITY CARE QUALITY OF CARE RESPECT RISK ADJUSTMENT SCREENING SHARE OF HEALTH SPENDING SICKNESS FUNDS SOCIAL HEALTH INSURANCE SOCIAL SECURITY TREATMENT TUBERCULOSIS TUBERCULOSIS CONTROL UNEMPLOYMENT WAR WORKERS WORKING-AGE POPULATION WORLD HEALTH ORGANIZATION This paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spending, amenable mortality, and labor market outcomes. The paper uses regression-based generalizations of difference-in-differences and instrumental variables to address the possible endogeneity of a country's health system. It finds that adopting social health insurance in preference to tax financing increases per capita health spending by 3-4 percent, reduces the formal sector share of employment by 8-10 percent, and reduces total employment by as much as 6 percent. For the most part, social health insurance adoption has no significant impact on amenable mortality, but for one cause-breast cancer among women-social health insurance systems perform significantly worse, with 5-6 percent more potential years of life lost. 2012-03-19T19:08:26Z 2012-03-19T19:08:26Z 2009-01-01 http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20090121101737 http://hdl.handle.net/10986/4018 English Policy Research working paper ; no. WPS 4821 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank Publications & Research :: Policy Research Working Paper East Asia and Pacific
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
topic AGE GROUPS
AGED
BREAST CANCER
CANCERS
CAPITA HEALTH SPENDING
CAPITATION
CAPITATION SYSTEM
CAUSES OF DEATH
CERVICAL CANCER
COLON CANCER
COMPARISONS OF HEALTH EXPENDITURE
COMPETITION BETWEEN HOSPITALS
DEATH RATE
DEATH RATES
DEATHS
DEMOCRACY
DEVELOPING COUNTRIES
DIABETES
DIAGNOSIS
DISEASES
EARLY DETECTION
EXPENDITURES
FEE-FOR-SERVICE
FEMALES
GLOBAL BUDGETS
HEALTH AUTHORITIES
HEALTH CARE
HEALTH CARE COSTS
HEALTH CARE COVERAGE
HEALTH CARE FINANCING
HEALTH CARE NEEDS
HEALTH CARE PROVIDERS
HEALTH CARE REFORM
HEALTH CARE SYSTEM
HEALTH CARE SYSTEMS
HEALTH CARE SYSTEMS IN TRANSITION
HEALTH CARE UTILIZATION
HEALTH DATA
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURE PER CAPITA
HEALTH FINANCE
HEALTH FINANCING
HEALTH FINANCING SYSTEM
HEALTH IMPACTS
HEALTH INSURANCE
HEALTH INSURANCE COVERAGE
HEALTH INSURANCE FUNDS
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH PLANNING
HEALTH POLICY
HEALTH SECTOR
HEALTH SECTOR REFORM
HEALTH SERVICES
HEALTH SERVICES RESEARCH
HEALTH STATUS
HEALTH STATUS INDICATORS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTH SYSTEMS IN TRANSITION
HEART DISEASE
HOSPITAL
HOSPITALS
HUMAN DEVELOPMENT
ILLNESS
IMMUNIZATIONS
INCOME
INCOME COUNTRIES
INDIVIDUAL MEMBERS
INEQUITIES
INEQUITIES IN HEALTH CARE
INFLUENZA
INFORMAL SECTOR
INFORMAL SECTOR WORKERS
INPATIENT ADMISSIONS
INSURANCE MARKET
INSURANCE SCHEMES
INSURANCE SYSTEMS
INSURERS
INTEGRATION
INTERNATIONAL COMPARISONS
LABOR MARKET
LABOR MARKETS
LEVEL OF HEALTH SPENDING
LIFE EXPECTANCY
MALIGNANT NEOPLASMS
MARKET ECONOMY
MATERNAL DEATH
MEDICAL CARE
MORTALITY
NATIONAL HEALTH
NATIONAL HEALTH INSURANCE
NATIONAL HEALTH SPENDING
NUMBER OF PEOPLE
PATIENTS
PERSONAL HEALTH
PHYSICIANS
PNEUMONIA
POCKET PAYMENTS
POLICY RESEARCH
POLICY RESEARCH WORKING PAPER
POPULATION STUDIES
PREGNANCY
PREMATURE DEATH
PRIMARY CARE
PRIVATE INSURANCE
PRIVATE SECTOR
PROGRESS
PROVIDER PAYMENT
PROVISION OF HEALTH CARE
PROVISION OF SERVICES
PUBLIC HEALTH
PUBLIC HEALTH CARE
PUBLIC HEALTH PROGRAMS
PUBLIC HEALTH SYSTEM
PUBLIC HOSPITALS
PUBLIC SERVICES
PURCHASER-PROVIDER SPLIT
PURCHASING POWER
QUALITY CARE
QUALITY OF CARE
RESPECT
RISK ADJUSTMENT
SCREENING
SHARE OF HEALTH SPENDING
SICKNESS FUNDS
SOCIAL HEALTH INSURANCE
SOCIAL SECURITY
TREATMENT
TUBERCULOSIS
TUBERCULOSIS CONTROL
UNEMPLOYMENT
WAR
WORKERS
WORKING-AGE POPULATION
WORLD HEALTH ORGANIZATION
spellingShingle AGE GROUPS
AGED
BREAST CANCER
CANCERS
CAPITA HEALTH SPENDING
CAPITATION
CAPITATION SYSTEM
CAUSES OF DEATH
CERVICAL CANCER
COLON CANCER
COMPARISONS OF HEALTH EXPENDITURE
COMPETITION BETWEEN HOSPITALS
DEATH RATE
DEATH RATES
DEATHS
DEMOCRACY
DEVELOPING COUNTRIES
DIABETES
DIAGNOSIS
DISEASES
EARLY DETECTION
EXPENDITURES
FEE-FOR-SERVICE
FEMALES
GLOBAL BUDGETS
HEALTH AUTHORITIES
HEALTH CARE
HEALTH CARE COSTS
HEALTH CARE COVERAGE
HEALTH CARE FINANCING
HEALTH CARE NEEDS
HEALTH CARE PROVIDERS
HEALTH CARE REFORM
HEALTH CARE SYSTEM
HEALTH CARE SYSTEMS
HEALTH CARE SYSTEMS IN TRANSITION
HEALTH CARE UTILIZATION
HEALTH DATA
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURE PER CAPITA
HEALTH FINANCE
HEALTH FINANCING
HEALTH FINANCING SYSTEM
HEALTH IMPACTS
HEALTH INSURANCE
HEALTH INSURANCE COVERAGE
HEALTH INSURANCE FUNDS
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH PLANNING
HEALTH POLICY
HEALTH SECTOR
HEALTH SECTOR REFORM
HEALTH SERVICES
HEALTH SERVICES RESEARCH
HEALTH STATUS
HEALTH STATUS INDICATORS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTH SYSTEMS IN TRANSITION
HEART DISEASE
HOSPITAL
HOSPITALS
HUMAN DEVELOPMENT
ILLNESS
IMMUNIZATIONS
INCOME
INCOME COUNTRIES
INDIVIDUAL MEMBERS
INEQUITIES
INEQUITIES IN HEALTH CARE
INFLUENZA
INFORMAL SECTOR
INFORMAL SECTOR WORKERS
INPATIENT ADMISSIONS
INSURANCE MARKET
INSURANCE SCHEMES
INSURANCE SYSTEMS
INSURERS
INTEGRATION
INTERNATIONAL COMPARISONS
LABOR MARKET
LABOR MARKETS
LEVEL OF HEALTH SPENDING
LIFE EXPECTANCY
MALIGNANT NEOPLASMS
MARKET ECONOMY
MATERNAL DEATH
MEDICAL CARE
MORTALITY
NATIONAL HEALTH
NATIONAL HEALTH INSURANCE
NATIONAL HEALTH SPENDING
NUMBER OF PEOPLE
PATIENTS
PERSONAL HEALTH
PHYSICIANS
PNEUMONIA
POCKET PAYMENTS
POLICY RESEARCH
POLICY RESEARCH WORKING PAPER
POPULATION STUDIES
PREGNANCY
PREMATURE DEATH
PRIMARY CARE
PRIVATE INSURANCE
PRIVATE SECTOR
PROGRESS
PROVIDER PAYMENT
PROVISION OF HEALTH CARE
PROVISION OF SERVICES
PUBLIC HEALTH
PUBLIC HEALTH CARE
PUBLIC HEALTH PROGRAMS
PUBLIC HEALTH SYSTEM
PUBLIC HOSPITALS
PUBLIC SERVICES
PURCHASER-PROVIDER SPLIT
PURCHASING POWER
QUALITY CARE
QUALITY OF CARE
RESPECT
RISK ADJUSTMENT
SCREENING
SHARE OF HEALTH SPENDING
SICKNESS FUNDS
SOCIAL HEALTH INSURANCE
SOCIAL SECURITY
TREATMENT
TUBERCULOSIS
TUBERCULOSIS CONTROL
UNEMPLOYMENT
WAR
WORKERS
WORKING-AGE POPULATION
WORLD HEALTH ORGANIZATION
Wagstaff, Adam
Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
geographic_facet East Asia and Pacific
relation Policy Research working paper ; no. WPS 4821
description This paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spending, amenable mortality, and labor market outcomes. The paper uses regression-based generalizations of difference-in-differences and instrumental variables to address the possible endogeneity of a country's health system. It finds that adopting social health insurance in preference to tax financing increases per capita health spending by 3-4 percent, reduces the formal sector share of employment by 8-10 percent, and reduces total employment by as much as 6 percent. For the most part, social health insurance adoption has no significant impact on amenable mortality, but for one cause-breast cancer among women-social health insurance systems perform significantly worse, with 5-6 percent more potential years of life lost.
format Publications & Research :: Policy Research Working Paper
author Wagstaff, Adam
author_facet Wagstaff, Adam
author_sort Wagstaff, Adam
title Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
title_short Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
title_full Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
title_fullStr Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
title_full_unstemmed Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD
title_sort social health insurance vs. tax-financed health systems—evidence from the oecd
publishDate 2012
url http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20090121101737
http://hdl.handle.net/10986/4018
_version_ 1764389524177158144