The Economic Consequences of Health Shocks

While there is a great deal of anecdotal evidence on the economic effects of adverse health shocks, there is relatively little hard empirical evidence. The author builds on recent empirical work to explore in the context of postreform Vietnam two related issues: (1) how far household income and medi...

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Main Author: Wagstaff, Adam
Format: Policy Research Working Paper
Language:English
Published: World Bank, Washington, DC 2012
Subjects:
Online Access:http://documents.worldbank.org/curated/en/2005/06/5866253/economic-consequences-health-shocks
http://hdl.handle.net/10986/8307
id okr-10986-8307
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
topic AGRICULTURAL OUTPUT
CONSUMPTION GROWTH
CONSUMPTION INSURANCE
CONSUMPTION SMOOTHING
DESCRIPTIVE STATISTICS
DEVELOPING COUNTRIES
DEVELOPING WORLD
DEVELOPMENT ECONOMICS
ECONOMIC CONSEQUENCES
ECONOMIC GROWTH
ECONOMIC PERSPECTIVES
ECONOMIC REVIEW
ECONOMIC THEORY
EMPIRICAL ANALYSIS
EMPIRICAL EVIDENCE
EMPIRICAL WORK
EXPENDITURES
GROWTH EQUATIONS
HEALTH CARE
HEALTH CARE COSTS
HEALTH FINANCE
HEALTH INSURANCE
HEALTH SECTOR
HEALTH STATUS
HOUSEHOLD CONSUMPTION
HOUSEHOLD INCOME
HOUSEHOLD MEMBERS
HOUSEHOLD SIZE
HUMAN CAPITAL
INCOME
INCOME DISTRIBUTION
INCOME EFFECT
INCOME EQUATION
INCOME RISK
INCOME SHOCKS
INCOME-POVERTY
INCOMES
INEQUALITY
INSURANCE
LABOR MARKET
LABOR SUPPLY
LEGISLATION
LIVING STANDARDS
MEDICAL CARE
MEDICAL CARE COSTS
MEDICAL COSTS
MEDICAL EXPENSES
MORTALITY
NEGATIVE COEFFICIENT
NEGATIVE GROWTH
NUTRITION
NUTRITIONAL STATUS
PACIFIC REGION
PARTIAL INSURANCE
PER CAPITA INCOME
POLICY RESEARCH
POLITICAL ECONOMY
POOR
POOR HOUSEHOLDS
POOR PEOPLE
PRIMARY HEALTH CARE
PRIVATE SECTOR
PRODUCTION FUNCTION
PRODUCTIVITY
RISK SHARING
SIGNIFICANT DIFFERENCES
SIGNIFICANT EFFECT
TARGETING
USE VALUE
WAGES
spellingShingle AGRICULTURAL OUTPUT
CONSUMPTION GROWTH
CONSUMPTION INSURANCE
CONSUMPTION SMOOTHING
DESCRIPTIVE STATISTICS
DEVELOPING COUNTRIES
DEVELOPING WORLD
DEVELOPMENT ECONOMICS
ECONOMIC CONSEQUENCES
ECONOMIC GROWTH
ECONOMIC PERSPECTIVES
ECONOMIC REVIEW
ECONOMIC THEORY
EMPIRICAL ANALYSIS
EMPIRICAL EVIDENCE
EMPIRICAL WORK
EXPENDITURES
GROWTH EQUATIONS
HEALTH CARE
HEALTH CARE COSTS
HEALTH FINANCE
HEALTH INSURANCE
HEALTH SECTOR
HEALTH STATUS
HOUSEHOLD CONSUMPTION
HOUSEHOLD INCOME
HOUSEHOLD MEMBERS
HOUSEHOLD SIZE
HUMAN CAPITAL
INCOME
INCOME DISTRIBUTION
INCOME EFFECT
INCOME EQUATION
INCOME RISK
INCOME SHOCKS
INCOME-POVERTY
INCOMES
INEQUALITY
INSURANCE
LABOR MARKET
LABOR SUPPLY
LEGISLATION
LIVING STANDARDS
MEDICAL CARE
MEDICAL CARE COSTS
MEDICAL COSTS
MEDICAL EXPENSES
MORTALITY
NEGATIVE COEFFICIENT
NEGATIVE GROWTH
NUTRITION
NUTRITIONAL STATUS
PACIFIC REGION
PARTIAL INSURANCE
PER CAPITA INCOME
POLICY RESEARCH
POLITICAL ECONOMY
POOR
POOR HOUSEHOLDS
POOR PEOPLE
PRIMARY HEALTH CARE
PRIVATE SECTOR
PRODUCTION FUNCTION
PRODUCTIVITY
RISK SHARING
SIGNIFICANT DIFFERENCES
SIGNIFICANT EFFECT
TARGETING
USE VALUE
WAGES
Wagstaff, Adam
The Economic Consequences of Health Shocks
geographic_facet East Asia and Pacific
Vietnam
relation Policy Research Working Paper; No. 3644
description While there is a great deal of anecdotal evidence on the economic effects of adverse health shocks, there is relatively little hard empirical evidence. The author builds on recent empirical work to explore in the context of postreform Vietnam two related issues: (1) how far household income and medical care spending responds to health shocks, and (2) how far household consumption is protected against health shocks. The results suggest that adverse health shocks - captured by negative changes in body mass index (BMI) - are associated with reductions in earned income. This appears to be only partly - if at all - due to a reverse feedback from income changes to BMI changes. By contrast, there is a hint - the relevant coefficient is not significant - that adverse BMI shocks may result in increases in unearned income. This may reflect additional gifts, remittances, and so on, from family and friends following the health shock. Medical spending is found to increase following an adverse health shock, but not among those with health insurance. The impact for the uninsured is large, equal in absolute size to the income loss associated with a BMI shock. The lack of impact for the insured points to complete insurance against the medical care costs associated with health shocks, and is consistent with the very generous coverage of Vietnam's health insurance program in this period. The question arises: have Vietnamese households been able to hold their food and nonfood consumption constant in the face of these income reductions and extra medical care outlays? The results suggest not. For the sample as a whole, both food and nonfood consumption are found to be responsive to health shocks, indicating an inability to smooth nonmedical consumption in the face of health shocks. Further analysis reveals some interesting differences across different groups within the sample. Households with insurance come no closer to smoothing nonmedical consumption than uninsured households. Furthermore, and somewhat counterintuitively, better-off households - including insured households - fare worse than poorer households in smoothing their nonmedical consumption in the face of health shocks, despite the fact that in the case of insured households there are no medical bills associated with an adverse health event. Why the poor rely on dissaving and borrowing to such an extent, and do not apparently reduce their food and nonfood consumption following an adverse health shock while the better-off do, may be because the levels of food and nonfood consumption of the poor are simply too low relative to basic needs to enable them to cut back in the face of an adverse BMI shock.
format Publications & Research :: Policy Research Working Paper
author Wagstaff, Adam
author_facet Wagstaff, Adam
author_sort Wagstaff, Adam
title The Economic Consequences of Health Shocks
title_short The Economic Consequences of Health Shocks
title_full The Economic Consequences of Health Shocks
title_fullStr The Economic Consequences of Health Shocks
title_full_unstemmed The Economic Consequences of Health Shocks
title_sort economic consequences of health shocks
publisher World Bank, Washington, DC
publishDate 2012
url http://documents.worldbank.org/curated/en/2005/06/5866253/economic-consequences-health-shocks
http://hdl.handle.net/10986/8307
_version_ 1764407593211527168
spelling okr-10986-83072021-04-23T14:02:43Z The Economic Consequences of Health Shocks Wagstaff, Adam AGRICULTURAL OUTPUT CONSUMPTION GROWTH CONSUMPTION INSURANCE CONSUMPTION SMOOTHING DESCRIPTIVE STATISTICS DEVELOPING COUNTRIES DEVELOPING WORLD DEVELOPMENT ECONOMICS ECONOMIC CONSEQUENCES ECONOMIC GROWTH ECONOMIC PERSPECTIVES ECONOMIC REVIEW ECONOMIC THEORY EMPIRICAL ANALYSIS EMPIRICAL EVIDENCE EMPIRICAL WORK EXPENDITURES GROWTH EQUATIONS HEALTH CARE HEALTH CARE COSTS HEALTH FINANCE HEALTH INSURANCE HEALTH SECTOR HEALTH STATUS HOUSEHOLD CONSUMPTION HOUSEHOLD INCOME HOUSEHOLD MEMBERS HOUSEHOLD SIZE HUMAN CAPITAL INCOME INCOME DISTRIBUTION INCOME EFFECT INCOME EQUATION INCOME RISK INCOME SHOCKS INCOME-POVERTY INCOMES INEQUALITY INSURANCE LABOR MARKET LABOR SUPPLY LEGISLATION LIVING STANDARDS MEDICAL CARE MEDICAL CARE COSTS MEDICAL COSTS MEDICAL EXPENSES MORTALITY NEGATIVE COEFFICIENT NEGATIVE GROWTH NUTRITION NUTRITIONAL STATUS PACIFIC REGION PARTIAL INSURANCE PER CAPITA INCOME POLICY RESEARCH POLITICAL ECONOMY POOR POOR HOUSEHOLDS POOR PEOPLE PRIMARY HEALTH CARE PRIVATE SECTOR PRODUCTION FUNCTION PRODUCTIVITY RISK SHARING SIGNIFICANT DIFFERENCES SIGNIFICANT EFFECT TARGETING USE VALUE WAGES While there is a great deal of anecdotal evidence on the economic effects of adverse health shocks, there is relatively little hard empirical evidence. The author builds on recent empirical work to explore in the context of postreform Vietnam two related issues: (1) how far household income and medical care spending responds to health shocks, and (2) how far household consumption is protected against health shocks. The results suggest that adverse health shocks - captured by negative changes in body mass index (BMI) - are associated with reductions in earned income. This appears to be only partly - if at all - due to a reverse feedback from income changes to BMI changes. By contrast, there is a hint - the relevant coefficient is not significant - that adverse BMI shocks may result in increases in unearned income. This may reflect additional gifts, remittances, and so on, from family and friends following the health shock. Medical spending is found to increase following an adverse health shock, but not among those with health insurance. The impact for the uninsured is large, equal in absolute size to the income loss associated with a BMI shock. The lack of impact for the insured points to complete insurance against the medical care costs associated with health shocks, and is consistent with the very generous coverage of Vietnam's health insurance program in this period. The question arises: have Vietnamese households been able to hold their food and nonfood consumption constant in the face of these income reductions and extra medical care outlays? The results suggest not. For the sample as a whole, both food and nonfood consumption are found to be responsive to health shocks, indicating an inability to smooth nonmedical consumption in the face of health shocks. Further analysis reveals some interesting differences across different groups within the sample. Households with insurance come no closer to smoothing nonmedical consumption than uninsured households. Furthermore, and somewhat counterintuitively, better-off households - including insured households - fare worse than poorer households in smoothing their nonmedical consumption in the face of health shocks, despite the fact that in the case of insured households there are no medical bills associated with an adverse health event. Why the poor rely on dissaving and borrowing to such an extent, and do not apparently reduce their food and nonfood consumption following an adverse health shock while the better-off do, may be because the levels of food and nonfood consumption of the poor are simply too low relative to basic needs to enable them to cut back in the face of an adverse BMI shock. 2012-06-18T18:34:58Z 2012-06-18T18:34:58Z 2005-06 http://documents.worldbank.org/curated/en/2005/06/5866253/economic-consequences-health-shocks http://hdl.handle.net/10986/8307 English Policy Research Working Paper; No. 3644 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 East Asia and Pacific Vietnam