DOI: 10.3886/e184523
title: Replication Data and Code for: The Prices in the Crises: What we are learning from twenty years of health insurance in low- and middle-income countries

description: Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of healthcare through publicly-operated facilities. We discuss two rationales for this transition. First, health insurance would boost fiscal revenues for healthcare, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the healthcare sector. Our essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. We argue that this is not because there was no room to improve the quality of care but because behavioral responses among healthcare providers have systematically undermined the objectives of these insurance schemes.
description: Households and healthcare providers in low- and middle-income countries.
description: The data used in this paper come from the Demographic Health Surveys conducted in multiple countries and from multiple published studies, from which we have <br><br><br>To access DHS survey data: register on DHS website dhsprogram.com/data/<br>Step 1: provide personal login information<br><br>Step 2: Create a new project<br>- Project title: The Prices in the Crises: What we are learning from twenty years of health insurance in low- and middle-income countries<br>- Co-researchers: leave blank<br>- Description of Study: Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of healthcare through publicly-operated facilities. We discuss two rationales for this transition. First, health insurance would boost fiscal revenues for healthcare, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the healthcare sector. Our essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. We argue that this is not because there was no room to improve the quality of care but because behavioral responses among healthcare providers have systematically undermined the objectives of these insurance schemes. <br>Step 3: Request Datasets for your Project<br>- drop down menu: select every region in drop down menu <br>For each region:<br>- select [Select All Surveys]<br>- click [Save Selection(s)]<br>- tick box on [Conditions of Use] and enter password when prompted<br>- click [Submit Data Request Now]<br><br>Data are available within 2 business days.<br><br>In addition to this, figures are also produced based on estimates from published studies or working paper. These are each self contained datasets that are in the replication files and will be used as necessary in the code file to produce the relevant figures.<br><br>