Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial
Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in w...
| Main Authors: | , , , |
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2014
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2014/06/19641542/encouraging-health-insurance-informal-sector-cluster-randomized-trial-encouraging-health-insurance-informal-sector-cluster-randomized-trial http://hdl.handle.net/10986/18768 |
| Summary: | Subsidized voluntary enrollment in
government-run health insurance schemes is often proposed as
a way of increasing coverage among informal sector workers
and their families. This paper reports the results of a
cluster randomized control trial in which 3,000 households
in 20 communes in Vietnam were randomly assigned at baseline
to a control group or one of three treatments: an
information leaflet about Vietnam s government-run scheme
and the benefits of health insurance; a voucher entitling
eligible household members to 25 percent off their annual
premium; and both. The four groups were balanced at
baseline. In the control group, 6.3 percent (82/1296) of
individuals were enrolled in the endline, compared with 6.3
percent (79/1257), 7.2 percent (96/1327), and 7.0 percent
(87/1245) in the information, subsidy, and combined
intervention groups; the adjusted odds ratios were 0.94,
1.12, and 1.15, respectively. Only among those reporting
poor health were any significant intervention effects found,
and only for the combined intervention: an enrollment rate
of 16.3 percent (33/202) compared with 8.3 percent (18/218)
in the control group, and an adjusted odds ratio of 2.50.
The results suggest limited opportunities to raise voluntary
health insurance enrollment through information campaigns
and subsidies, and that these interventions exacerbate
adverse selection. |
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