Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance

Health insurance can improve health-seeking behaviors and protect consumption from health shocks but may also crowd out informal insurance. This paper therefore examines whether impacts of health insurance depend on households’ access to informal insurance, as proxied for by mobile money usage. Base...

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Main Authors: Geng, Xin, Janssens, Wendy, Kramer, Berber, van der List, Marijn
Format: Journal Article
Language:Inglés
Published: Elsevier 2018
Subjects:
Online Access:https://hdl.handle.net/10568/147115
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author Geng, Xin
Janssens, Wendy
Kramer, Berber
van der List, Marijn
author_browse Geng, Xin
Janssens, Wendy
Kramer, Berber
van der List, Marijn
author_facet Geng, Xin
Janssens, Wendy
Kramer, Berber
van der List, Marijn
author_sort Geng, Xin
collection Repository of Agricultural Research Outputs (CGSpace)
description Health insurance can improve health-seeking behaviors and protect consumption from health shocks but may also crowd out informal insurance. This paper therefore examines whether impacts of health insurance depend on households’ access to informal insurance, as proxied for by mobile money usage. Based on high-frequency financial diaries data collected in rural Kenya, we find that households with weaker access to informal insurance cope with uninsured health shocks by lowering subsequent non-health expenditures by approximately 25 percent. These same households are able to smooth consumption when health shocks are insured, due to lower out-of-pocket health expenditures. In contrast, households with access to informal insurance are able to smooth consumption even in the absence of formal health insurance. For this latter group, health insurance increases healthcare utilization at formal clinics and does not crowd out gifts and remittances during weeks with health shocks. These findings provide guidance for insurance schemes aiming to target the most vulnerable populations.
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spelling CGSpace1471152025-02-24T06:49:34Z Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance Geng, Xin Janssens, Wendy Kramer, Berber van der List, Marijn insurance informal sector rural population low income groups health insurance shock household expenditure capacity development health care Health insurance can improve health-seeking behaviors and protect consumption from health shocks but may also crowd out informal insurance. This paper therefore examines whether impacts of health insurance depend on households’ access to informal insurance, as proxied for by mobile money usage. Based on high-frequency financial diaries data collected in rural Kenya, we find that households with weaker access to informal insurance cope with uninsured health shocks by lowering subsequent non-health expenditures by approximately 25 percent. These same households are able to smooth consumption when health shocks are insured, due to lower out-of-pocket health expenditures. In contrast, households with access to informal insurance are able to smooth consumption even in the absence of formal health insurance. For this latter group, health insurance increases healthcare utilization at formal clinics and does not crowd out gifts and remittances during weeks with health shocks. These findings provide guidance for insurance schemes aiming to target the most vulnerable populations. 2018-08-15 2024-06-21T09:11:23Z 2024-06-21T09:11:23Z Journal Article https://hdl.handle.net/10568/147115 en https://doi.org/10.2499/p15738coll2.133514 https://doi.org/10.1093/heapol/czz172 Open Access Elsevier Geng, Xin; Janssens, Wendy; Kramer, Berber; and van der List, Marijn. 2018. Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance. World Development 111(November 2018): 196-210. https://doi.org/10.1016/j.worlddev.2018.07.004
spellingShingle insurance
informal sector
rural population
low income groups
health insurance
shock
household expenditure
capacity development
health care
Geng, Xin
Janssens, Wendy
Kramer, Berber
van der List, Marijn
Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title_full Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title_fullStr Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title_full_unstemmed Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title_short Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance
title_sort health insurance a friend in need impacts of formal insurance and crowding out of informal insurance
topic insurance
informal sector
rural population
low income groups
health insurance
shock
household expenditure
capacity development
health care
url https://hdl.handle.net/10568/147115
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AT vanderlistmarijn healthinsuranceafriendinneedimpactsofformalinsuranceandcrowdingoutofinformalinsurance