Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand

The effects of access to health insurance: Evidence from a regression discontinuity design in Peru

“…Miller et al (2013), in contrast, find for Colombia that insurance lowers both mean inpatient medical spending and its variability. Likewise, Limwattananon et al (2015) find that health insurance coverage leads to a decrease in out-of-pocket spending in Thailand. To see what drives this and whether some types of spending were negatively affected, Table 3 reports estimates using the log of spending plus 1 in different categories as the dependent variable so that the reported effects are (approximately) average percentage changes in spending.…”

“…Finally, two recent papers, Gruber et al (2014) and Limwattananon et al (2015), investigate the effect of a large-scale increase in health insurance coverage for the poor in Thailand. They find that the program had positive effects on health care utilization, negative effects on out-of-pocket expenditures, and negative effects on child mortality rates.…”

Economic Impact of Illness With Health Insurance But Without Income Insurance

“…Previous research has demonstrated that the extension of health coverage to the informal sector did greatly reduce OOP spending, particularly at the top of the distribution (Limwattananon et al 2015) resulting in a substantial welfare gain from the reduction in exposure to medical expenditure risk.…”

“…Thailand's landmark Universal Coverage Scheme provides a fairly comprehensive package of medical care benefits to the four fifths of Thais who are not insured through formal sector employment. It has been shown to have increased access to medical care and substantially reduced exposure to medical expenditure risk (Gruber et al 2014, Limwattananon et al 2015. But sickness-and disability-related earnings insurance in Thailand, as in other developing countries, remains restricted to formal sector employees who form less than a third of the workforce.…”

“…There is no cost-sharing after the removal of a flat fee of 30 Baht (~$0.75) in 2006. Per capita funding is much less generous than the coverage provided to civil servants but the scheme has been found to have strongly increased health care access with consequent gains in health (Gruber et al 2014) and to have substantially reduced OOP health payments (Limwattananon et al 2015). Nonetheless, possibly due to long waiting times, limited facility opening hours or perceived quality deficiencies, over 40% of the scheme's intended 1 Employers and the self-employed can voluntarily enroll in this scheme.…”