Crowding Out of Solidarity? – Public Health Insurance versus Informal Transfer Networks in Ghana

Klohn, Florian; Strupat, Christoph

doi:10.2139/ssrn.2306951

Cited by 5 publications

(4 citation statements)

References 15 publications

(5 reference statements)

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“…A growing literature deals with the consequences for informal support, i.e. monetary transfers provided by relatives, neighbors and friends, when insurance is introduced (Attanasio and Rios-Rull 2000;Hintz 2010;Landmann, Vollan, and Frölich 2012;Boucher and Delpierre 2014;Lin, Liu, and Meng 2014;Klohn and Strupat 2015). This literature investigates the extent of crowding out: if insurance crowds out informal support and delivers only incomplete risk coverage (for example, because not everybody gets insured, insurance does not fully compensate losses, or not all risks are insurable), introducing insurance does not necessarily lead to welfare improvements.…”

Section: Introductionmentioning

confidence: 99%

Insurance and Solidarity: Evidence from a Lab-in-The-Field Experiment in Cambodia

Lenel

Steiner

2017

SSRN Journal

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Any opinions expressed in this paper are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but IZA takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The IZA Institute of Labor Economics is an independent economic research institute that conducts research in labor economics and offers evidence-based policy advice on labor market issues. Supported by the Deutsche Post Foundation, IZA runs the world's largest network of economists, whose research aims to provide answers to the global labor market challenges of our time. Our key objective is to build bridges between academic research, policymakers and society. IZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author.

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Section: Introductionmentioning

confidence: 99%

Insurance and Solidarity: Evidence from a Lab-in-The-Field Experiment in Cambodia

Lenel

Steiner

2017

SSRN Journal

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“…There is ambiguous evidence on whether expanded formal transfers weaken existing informal safety nets. In Ghana the introduction of a formal health insurance scheme appears to have crowded out informal transfers, due to a reduced willingness to contribute to transfer networks (Klohn and Strupat, 2013). Conversely, in urban Papua New Guinea workers living in traditional villages in urban areas (and so they stay embedded in the social relationships that sustain informal solidarity networks) do not opt out even when they have access to formal sources of insurance and other types of social protection (Boe- Gibson et al, 1998).…”

Section: Limited Understanding Of Complex Responses To Transfersmentioning

confidence: 99%

Benefits and Costs of the Poverty Targets for the Post-2015 Development Agenda

Gibson¹

2018

Prioritizing Development

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Within the area of poverty, the target with the best benefit cost-ratio is:  Eliminate extreme poverty which as a benefit-to-cost ratio of 4-6. The remaining targets are relatively ineffective, or there is large uncertainty in the benefit-to-cost ratio.  Cover x% of people who are poor and vulnerable with social protection systems  Build resilience of the poor and reduce by x% deaths and economic losses related to disasters  Ensure equality of economic opportunity for all women and men, including secure rights to own land, property and other productive assets and access to financial services for all women and men  Achieve full and productive employment for all, including women and young people  Every country will monitor the wellbeing of its citizenry with improved measurements and reporting of life satisfaction SUMMARY OF RECCOMDATIONS TARGET Benefit Cost Ratio Rating Eliminate extreme poverty 4-6 GOOD Cover x% of people who are poor and vulnerable with social protection systems <1 POOR Build resilience of the poor and reduce by x% deaths and economic losses related to disasters <1 POOR Ensure equality of economic opportunity for all women and men, including secure rights to own land, property and other productive assets and access to financial services for all women and men Varies by sector UNCERTAIN Achieve full and productive employment for all, including women and young people <1 POOR Every country will monitor the wellbeing of its citizenry with improved measurements and reporting of life satisfaction <1 POOR II

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“…Contrariwise, other studies, mainly focusing broadly on social capital, have suggested that reciprocal support within social networks may facilitate insurance uptake by enabling individuals to afford the financial cost of scheme membership . Most studies are based on the reverse impact of formal health insurance on informal support, with the majority reporting a negative effect . Ligon et al explained that because formal health insurance provides an alternative protection against illness, it tends to reduce the social costs associated with nonparticipation in informal social protection systems.…”

Section: Introductionmentioning

confidence: 99%

Effect of informal financial support for health care on health Insurance uptake: Evidence from a mixed‐methods study in Tamale metropolis of northern Ghana

Alhassan

2018

Health Planning & Management

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Attempts to study the determinants of health insurance enrollment in resource-poor settings have often given less consideration to the potential influence of informal risk-sharing systems on individuals and households' decisions about health insurance. This paper contributes to existing discussions in this area by examining the effect of informal financial support for health care, an example of informal risk-sharing arrangement, on enrollment in the Ghana National Health Insurance Scheme (NHIS). It is based on a mixed-methods research in Tamale metropolis of northern Ghana. The study found widespread availability and reliance on informal support among low-income households to finance out-of-pocket health-care expenditure. Informal financial support for enrollment into the NHIS was noted to be less available. The study further found less strong but suggestive evidence that the perceived availability of informal financial support for health care by individuals diminishes their enrollment in the NHIS. The paper emphasizes the need for theory and policy on health insurance uptake in resource-constrained settings to consider existing informal risk-sharing arrangements as much as other known determinants of enrollment.

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Crowding Out of Solidarity? – Public Health Insurance versus Informal Transfer Networks in Ghana

Cited by 5 publications

References 15 publications

Insurance and Solidarity: Evidence from a Lab-in-The-Field Experiment in Cambodia

Insurance and Solidarity: Evidence from a Lab-in-The-Field Experiment in Cambodia

Benefits and Costs of the Poverty Targets for the Post-2015 Development Agenda

Effect of informal financial support for health care on health Insurance uptake: Evidence from a mixed‐methods study in Tamale metropolis of northern Ghana

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