The Impact of Health Insurance in Low- And Middle-Income Countries

Index

205 A access and use impact of health insurance on, 17 increased, 181 access to care barriers to, 148, 163, 181 RMHC increasing probability of, 148 Act for the Worker’s Protection, in Costa Rica, 91 acute illness, reported prevalence in Namibia, 38 acute respiratory infection, in Peru, 112, 114, 195 adult weight loss. See weight loss adverse selection data reflecting, 144–146 in enrollment in NHIS, 68 health insurance plagued by, 185 as an NHIS concern, 78 into private insurance schemes, 41 affiliation, with health insurance system in Costa Rica, 92–93 African countries, epidemics, 33 age structure, of insured and uninsured in Costa Rica, 95 age-based exemptions to NHIS, 69 AIDS, accompanied by weight loss, 46 analytical methods, for NHIS study, 83, 85 Index 206Index anemia, in Ghana, 59 antiretroviral therapy, in Namibia, 34, 46 Asabri, for police, military, and dependents, 123 Askes, social health insurance program, 123 Askeskin health insurance program, 9, 123 asset score, lower for uninsured households, 48 B balancing properties, propensity score matching , 146, 147 barriers to access, 148, 163, 181 baseline sample, 81 beneficiary identification system, 157 benefits package(s) established by the government in Colombia , 158 of NHIS as financially unsustainable, 79 of RMHC, 140 in subsidized regime, 170 bidirectional causality, 24 biomedical survey, with HIV test data, 33 Brazil, impact of supplemental private health insurance on self-perceived health status, 24 C Caja Costarricense del Seguro Social (the Caja), 89, 90–91, 95 care-seeking, in Ghana, 71, 78 catastrophic expenditure incidence of, 168–169 priority for NCMS in China, 137 reduction in, 151 RMHC reducing, 148 vulnerability increasing for poorest individuals , 168 catastrophic financial loss, 185 catastrophic health care, 21 catastrophic insurance, in Costa Rica, 102 Catholic Diocese of Sunyani, 60 causal chain, poorly specified, 186–187 children with acute respiratory infections, 112 benefits to insured, 164 with diarrhea, 112 DPT vaccinations of in Peru, 106 gaining insurance increasing use, 125 health insurance impacts on in Indonesia, 132–134 immunizations, 112, 164 insurance impacts on, 130 insured differences from uninsured, 124 premium exemption for NHIS more like for, 69 China case study, 10 health insurance reducing rates of catastrophic spending, 185 impact of rural mutual health care, 137–153 national tuberculosis strategies, 193 observed impacts of health insurance, 183 reducing copayments and coinsurance while building trust, 191–194 social experiment understating impacts, 187 studies on, 16 summary data on, 7 uneven evidence in studies, 189 chronic conditions, in Costa Rica, 100 chronic disease, in Namibia, 37–38 chronic illness, in Ghana, 68 claims payments, delays in Ghana, 63 cohabitation, with a Caja member, 96 coinsurance, policies on, 187 Index207 Colombia case study, 10 challenges remaining, 175 comparison of insured poor against uninsured poor, 11 gross national income, 157 health insurance reform, 155–175 health sector reform, 157–159 health system flows of funds and affiliations , 159 impacts of health insurance, 183 out-of-pocket expenditures increasing for costly illnesses, 185 poor gaining benefits from insurance coverage, 181 scaling up universal health insurance, 195 self-employed in contributory scheme, 181 studies on, 16 summary data on, 7 Colombian Demographic and Health Surveys (DHS), 156 communicable diseases in Ghana, 59, 190 in Namibia, 34 community governance, used by RMHC, 142 community-based health insurance schemes in Ghana, 60 positive effect on health status, 23 community-based prepayment scheme experimental, 192 social experiment of, 137 contributory regime in Colombia, 164, 166–167 benefits package, 158 copayments, 171 for employed and self-employed, 155 growth in coverage of, 161–162 impact on access barriers for selfemployed , 167 impact on health-related outcome variables , 156 impact on incidence of catastrophic expenditure, 172 increased access to and use of health services, 173 mitigating effect in face of catastrophic spending, 170–171, 172 Cooperative Medical System, collapse of in China, 10, 138, 191 copayments absence of, 90 policies on, 187 required under contributory regime, 171 Costa Rica case study of, 8–9 effect of social health insurance on child and infant mortality, 22 financial protection to everyone, 185 guaranteeing access to uninsured, 197 health system, 90–93 impact of health insurance, 89–103, 182 reducing per capita spending on health, 184 studies on, 16 summary data on, 7 universal health coverage, 89, 196–197 countries selecting for case studies, 6–10, 178 summary data on, 7 cream-skimming, 37 cross country studies, 16 curative health care NHIS causing an increase in use...