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American Economic Review Vol. 111 No. 9 2021

The Challenges of Universal Health Insurance in Developing Countries: Experimental Evidence from Indonesia’s National Health Insurance

Abhijit Banerjee1; Amy Finkelstein1; Rema Hanna2; Benjamin A. Olken1; Arianna Ornaghi3; Sudarno Sumarto4

1 MIT (email: ) · 2 Harvard University (email: ) · 3 University of Warwick (email: ) · 4 TNP2K and SMERU (email: )

open access

Abstract

To investigate barriers to universal health insurance in developing countries, we designed a randomized experiment involving about 6,000 households in Indonesia who are subject to a government health insurance program with a weakly enforced mandate. Time-limited subsidies increased enrollment and attracted lower-cost enrollees, in part by reducing the strategic timing of enrollment to correspond with health needs. Registration assistance also increased enrollment, but increased attempted enrollment much more, as over one-half of households who attempted to enroll did not successfully do so. These findings underscore how weak administrative capacity can create important challenges in developing countries for achieving widespread coverage.

DOI
10.1257/aer.20200523
Volume
111
Issue
9
Pages
3035-3063
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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