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

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...

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Main Authors:	Wagstaff, Adam, Moreno-Serra, Rodrigo
Format:	Policy Research Working Paper
Language:	English
Published:	World Bank, Washington, DC 2012
Subjects:	AGED APPENDICITIS ARI BREAST CANCER BRONCHITIS CAESAREAN SECTIONS CANCERS CAPITA HEALTH SPENDING CAPITAL SPENDING CENTRAL ASIAN CENTRAL FUND CEREBROVASCULAR DISEASES CONTRACTS WITH PROVIDERS CONTRIBUTION RATES COST OF HEALTH CARE DEATH RATES DEATHS DELIVERY OF HEALTH CARE DEVELOPING COUNTRIES DIABETES DIAGNOSIS DIARRHOEA DIGESTIVE DISEASES DISABILITY DISEASE DIVORCE DRUGS FEE-FOR-SERVICE FINANCIAL RESOURCES GI HEALTH CARE HEALTH CARE EXPENDITURES HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CONDITIONS HEALTH ECONOMISTS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURES HEALTH EXPENDITURES PER CAPITA HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH FOR ALL HEALTH INDICATORS HEALTH INFORMATION HEALTH INSURANCE HEALTH INSURERS HEALTH MINISTRIES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICIES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROVIDERS HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEALTH WORKERS HEART DISEASE HEPATITIS HEPATITIS B HOSPITAL HOSPITAL ADMISSIONS HOSPITAL BEDS HOSPITAL CARE HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INCOME INCOME GROUPS INFANT INFANT MORTALITY INFANT MORTALITY RATE INFECTION INFECTION RATE INFECTION RATES INFECTIOUS DISEASES INFORMAL SECTOR INPATIENT ADMISSIONS INSURANCE FUNDS INTERNATIONAL LABOR ORGANIZATION INTERNATIONAL ORGANIZATIONS LABOR MARKET LABOR MARKETS LABOR SUPPLY LATIN AMERICAN LAWS LIFE EXPECTANCY LIVER LIVER DISEASES LOW INCOME MEASLES MEASLES IMMUNIZATION MINISTRY OF HEALTH MORBIDITY MORBIDITY INDICATORS MORTALITY MUMPS NATIONAL HEALTH NATIONAL HEALTH SPENDING NEGATIVE EFFECTS NEONATAL MORTALITY NEOPLASMS PATIENT PATIENT ADMISSIONS PATIENTS PAYMENTS FOR HEALTH CARE PENSIONS PERTUSSIS PHYSICIANS POCKET PAYMENTS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLIO PREVALENCE PRIMARY CARE PRIVATE SECTOR PRIVATE SECTORS PRIVATE SPENDING PROBABILITY PROGRESS PROVIDER PAYMENT PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC SERVICES PURCHASING POWER PURCHASING POWER PARITY QUALITY OF CARE RESPECT RESPIRATORY DISEASES RUBELLA SHARE OF HEALTH SPENDING SMOKING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SUBSISTENCE FARMING SYPHILIS TETANUS TREATMENT TUBERCULOSIS UNDER-FIVE MORTALITY UNEMPLOYMENT UNEMPLOYMENT RATES URBAN POPULATION VISION WAR WORKERS WORLD HEALTH ORGANIZATION
Online Access:	http://documents.worldbank.org/curated/en/2007/10/8458168/europe-central-asias-great-post-communist-social-health-insurance-experiment-impacts-health-sector-labor-market-outcomes http://hdl.handle.net/10986/7382

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recordtype	oai_dc
spelling	okr-10986-73822021-04-23T14:02:34Z Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes Wagstaff, Adam Moreno-Serra, Rodrigo AGED APPENDICITIS ARI BREAST CANCER BRONCHITIS CAESAREAN SECTIONS CANCERS CAPITA HEALTH SPENDING CAPITAL SPENDING CENTRAL ASIAN CENTRAL FUND CEREBROVASCULAR DISEASES CONTRACTS WITH PROVIDERS CONTRIBUTION RATES COST OF HEALTH CARE DEATH RATES DEATHS DELIVERY OF HEALTH CARE DEVELOPING COUNTRIES DIABETES DIAGNOSIS DIARRHOEA DIGESTIVE DISEASES DISABILITY DISEASE DIVORCE DRUGS FEE-FOR-SERVICE FINANCIAL RESOURCES GI HEALTH CARE HEALTH CARE EXPENDITURES HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CONDITIONS HEALTH ECONOMISTS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURES HEALTH EXPENDITURES PER CAPITA HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH FOR ALL HEALTH INDICATORS HEALTH INFORMATION HEALTH INSURANCE HEALTH INSURERS HEALTH MINISTRIES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICIES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROVIDERS HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEALTH WORKERS HEART DISEASE HEPATITIS HEPATITIS B HOSPITAL HOSPITAL ADMISSIONS HOSPITAL BEDS HOSPITAL CARE HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INCOME INCOME GROUPS INFANT INFANT MORTALITY INFANT MORTALITY RATE INFECTION INFECTION RATE INFECTION RATES INFECTIOUS DISEASES INFORMAL SECTOR INPATIENT ADMISSIONS INSURANCE FUNDS INTERNATIONAL LABOR ORGANIZATION INTERNATIONAL ORGANIZATIONS LABOR MARKET LABOR MARKETS LABOR SUPPLY LATIN AMERICAN LAWS LIFE EXPECTANCY LIVER LIVER DISEASES LOW INCOME MEASLES MEASLES IMMUNIZATION MINISTRY OF HEALTH MORBIDITY MORBIDITY INDICATORS MORTALITY MUMPS NATIONAL HEALTH NATIONAL HEALTH SPENDING NEGATIVE EFFECTS NEONATAL MORTALITY NEOPLASMS PATIENT PATIENT ADMISSIONS PATIENTS PAYMENTS FOR HEALTH CARE PENSIONS PERTUSSIS PHYSICIANS POCKET PAYMENTS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLIO PREVALENCE PRIMARY CARE PRIVATE SECTOR PRIVATE SECTORS PRIVATE SPENDING PROBABILITY PROGRESS PROVIDER PAYMENT PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC SERVICES PURCHASING POWER PURCHASING POWER PARITY QUALITY OF CARE RESPECT RESPIRATORY DISEASES RUBELLA SHARE OF HEALTH SPENDING SMOKING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SUBSISTENCE FARMING SYPHILIS TETANUS TREATMENT TUBERCULOSIS UNDER-FIVE MORTALITY UNEMPLOYMENT UNEMPLOYMENT RATES URBAN POPULATION VISION WAR WORKERS WORLD HEALTH ORGANIZATION 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 to better 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. 2012-06-07T14:47:30Z 2012-06-07T14:47:30Z 2007-10 http://documents.worldbank.org/curated/en/2007/10/8458168/europe-central-asias-great-post-communist-social-health-insurance-experiment-impacts-health-sector-labor-market-outcomes http://hdl.handle.net/10986/7382 English Policy Research Working Paper; No. 4371 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research Europe and Central Asia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English
topic	AGED APPENDICITIS ARI BREAST CANCER BRONCHITIS CAESAREAN SECTIONS CANCERS CAPITA HEALTH SPENDING CAPITAL SPENDING CENTRAL ASIAN CENTRAL FUND CEREBROVASCULAR DISEASES CONTRACTS WITH PROVIDERS CONTRIBUTION RATES COST OF HEALTH CARE DEATH RATES DEATHS DELIVERY OF HEALTH CARE DEVELOPING COUNTRIES DIABETES DIAGNOSIS DIARRHOEA DIGESTIVE DISEASES DISABILITY DISEASE DIVORCE DRUGS FEE-FOR-SERVICE FINANCIAL RESOURCES GI HEALTH CARE HEALTH CARE EXPENDITURES HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CONDITIONS HEALTH ECONOMISTS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURES HEALTH EXPENDITURES PER CAPITA HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH FOR ALL HEALTH INDICATORS HEALTH INFORMATION HEALTH INSURANCE HEALTH INSURERS HEALTH MINISTRIES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICIES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROVIDERS HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEALTH WORKERS HEART DISEASE HEPATITIS HEPATITIS B HOSPITAL HOSPITAL ADMISSIONS HOSPITAL BEDS HOSPITAL CARE HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INCOME INCOME GROUPS INFANT INFANT MORTALITY INFANT MORTALITY RATE INFECTION INFECTION RATE INFECTION RATES INFECTIOUS DISEASES INFORMAL SECTOR INPATIENT ADMISSIONS INSURANCE FUNDS INTERNATIONAL LABOR ORGANIZATION INTERNATIONAL ORGANIZATIONS LABOR MARKET LABOR MARKETS LABOR SUPPLY LATIN AMERICAN LAWS LIFE EXPECTANCY LIVER LIVER DISEASES LOW INCOME MEASLES MEASLES IMMUNIZATION MINISTRY OF HEALTH MORBIDITY MORBIDITY INDICATORS MORTALITY MUMPS NATIONAL HEALTH NATIONAL HEALTH SPENDING NEGATIVE EFFECTS NEONATAL MORTALITY NEOPLASMS PATIENT PATIENT ADMISSIONS PATIENTS PAYMENTS FOR HEALTH CARE PENSIONS PERTUSSIS PHYSICIANS POCKET PAYMENTS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLIO PREVALENCE PRIMARY CARE PRIVATE SECTOR PRIVATE SECTORS PRIVATE SPENDING PROBABILITY PROGRESS PROVIDER PAYMENT PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC SERVICES PURCHASING POWER PURCHASING POWER PARITY QUALITY OF CARE RESPECT RESPIRATORY DISEASES RUBELLA SHARE OF HEALTH SPENDING SMOKING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SUBSISTENCE FARMING SYPHILIS TETANUS TREATMENT TUBERCULOSIS UNDER-FIVE MORTALITY UNEMPLOYMENT UNEMPLOYMENT RATES URBAN POPULATION VISION WAR WORKERS WORLD HEALTH ORGANIZATION
spellingShingle	AGED APPENDICITIS ARI BREAST CANCER BRONCHITIS CAESAREAN SECTIONS CANCERS CAPITA HEALTH SPENDING CAPITAL SPENDING CENTRAL ASIAN CENTRAL FUND CEREBROVASCULAR DISEASES CONTRACTS WITH PROVIDERS CONTRIBUTION RATES COST OF HEALTH CARE DEATH RATES DEATHS DELIVERY OF HEALTH CARE DEVELOPING COUNTRIES DIABETES DIAGNOSIS DIARRHOEA DIGESTIVE DISEASES DISABILITY DISEASE DIVORCE DRUGS FEE-FOR-SERVICE FINANCIAL RESOURCES GI HEALTH CARE HEALTH CARE EXPENDITURES HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CONDITIONS HEALTH ECONOMISTS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURES HEALTH EXPENDITURES PER CAPITA HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH FOR ALL HEALTH INDICATORS HEALTH INFORMATION HEALTH INSURANCE HEALTH INSURERS HEALTH MINISTRIES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICIES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROVIDERS HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEALTH WORKERS HEART DISEASE HEPATITIS HEPATITIS B HOSPITAL HOSPITAL ADMISSIONS HOSPITAL BEDS HOSPITAL CARE HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INCOME INCOME GROUPS INFANT INFANT MORTALITY INFANT MORTALITY RATE INFECTION INFECTION RATE INFECTION RATES INFECTIOUS DISEASES INFORMAL SECTOR INPATIENT ADMISSIONS INSURANCE FUNDS INTERNATIONAL LABOR ORGANIZATION INTERNATIONAL ORGANIZATIONS LABOR MARKET LABOR MARKETS LABOR SUPPLY LATIN AMERICAN LAWS LIFE EXPECTANCY LIVER LIVER DISEASES LOW INCOME MEASLES MEASLES IMMUNIZATION MINISTRY OF HEALTH MORBIDITY MORBIDITY INDICATORS MORTALITY MUMPS NATIONAL HEALTH NATIONAL HEALTH SPENDING NEGATIVE EFFECTS NEONATAL MORTALITY NEOPLASMS PATIENT PATIENT ADMISSIONS PATIENTS PAYMENTS FOR HEALTH CARE PENSIONS PERTUSSIS PHYSICIANS POCKET PAYMENTS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLIO PREVALENCE PRIMARY CARE PRIVATE SECTOR PRIVATE SECTORS PRIVATE SPENDING PROBABILITY PROGRESS PROVIDER PAYMENT PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC SERVICES PURCHASING POWER PURCHASING POWER PARITY QUALITY OF CARE RESPECT RESPIRATORY DISEASES RUBELLA SHARE OF HEALTH SPENDING SMOKING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SUBSISTENCE FARMING SYPHILIS TETANUS TREATMENT TUBERCULOSIS UNDER-FIVE MORTALITY UNEMPLOYMENT UNEMPLOYMENT RATES URBAN POPULATION VISION WAR WORKERS WORLD HEALTH ORGANIZATION Wagstaff, Adam Moreno-Serra, Rodrigo Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
geographic_facet	Europe and Central Asia
relation	Policy Research Working Paper; No. 4371
description	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 to better 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.
format	Publications & Research :: Policy Research Working Paper
author	Wagstaff, Adam Moreno-Serra, Rodrigo
author_facet	Wagstaff, Adam Moreno-Serra, Rodrigo
author_sort	Wagstaff, Adam
title	Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
title_short	Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
title_full	Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
title_fullStr	Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
title_full_unstemmed	Europe and Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts on Health Sector and Labor Market Outcomes
title_sort	europe and central asia's great post-communist social health insurance experiment : impacts on health sector and labor market outcomes
publisher	World Bank, Washington, DC
publishDate	2012
url	http://documents.worldbank.org/curated/en/2007/10/8458168/europe-central-asias-great-post-communist-social-health-insurance-experiment-impacts-health-sector-labor-market-outcomes http://hdl.handle.net/10986/7382
_version_	1764402441624748032

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

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