[go: up one dir, main page]

IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v96y2013icp264-271.html
   My bibliography  Save this article

Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme

Author

Listed:
  • Sparrow, Robert
  • Suryahadi, Asep
  • Widyanti, Wenefrida
Abstract
A first step towards meeting Indonesia's ambition for universal health insurance was made in 2005 with the introduction of the Askeskin programme, a subsidized social health insurance targeted to the informal sector and the poor. This paper investigates targeting and impact of the Askeskin programme using panel data for 8582 households observed in 2005 and 2006, and applying difference-in-differences estimation in combination with propensity score matching. We find that the programme is indeed targeted to the poor and those most vulnerable to catastrophic out-of-pocket health payments. Social health insurance improves access to health care in that it increases utilization of outpatient among the poor, while out-of-pocket spending seems to have increased for Askeskin insured in urban areas.

Suggested Citation

  • Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
  • Handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:264-271
    DOI: 10.1016/j.socscimed.2012.09.043
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612007095
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2012.09.043?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. De Weerdt, Joachim & Dercon, Stefan, 2006. "Risk-sharing networks and insurance against illness," Journal of Development Economics, Elsevier, vol. 81(2), pages 337-356, December.
    2. Antonio Trujillo & Jorge Portillo & John Vernon, 2005. "The Impact of Subsidized Health Insurance for the Poor: Evaluating the Colombian Experience Using Propensity Score Matching," International Journal of Health Economics and Management, Springer, vol. 5(3), pages 211-239, September.
    3. Kruse, Ioana & Pradhan, Menno & Sparrow, Robert, 2012. "Marginal benefit incidence of public health spending: Evidence from Indonesian sub-national data," Journal of Health Economics, Elsevier, vol. 31(1), pages 147-157.
    4. Alex Arifianto & Ruly Marianti & Sri Budiyati & Ellen Tan, 2005. "Making Services Work for the Poor in Indonesia : A Report on Health Financing Mechanisms (JPK-Gakin) Scheme in Kabupaten Purbalingga, East Sumba, and Tabanan," Development Economics Working Papers 22527, East Asian Bureau of Economic Research.
    5. DiPrete, Thomas A. & Gangl, Markus, 2004. "Assessing bias in the estimation of causal effects: Rosenbaum bounds on matching estimators and instrumental variables estimation with imperfect instruments," Discussion Papers, Research Unit: Labor Market Policy and Employment SP I 2004-101, WZB Berlin Social Science Center.
    6. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    7. Alex Arifianto & Ruly Marianti & Sri Budiyati & Ellen Tan, 2005. "Making Services Work for the Poor in Indonesia : A Report on Health Financing Mechanisms in Kabupaten Tabanan, Bali : A Case Study," Development Economics Working Papers 22523, East Asian Bureau of Economic Research.
    8. Galarrága, O & Sosa-Rubí, S. G & Salinas, A & Sesma, S, 2008. "The Impact of Universal Health Insurance on Catastrophic and Out-of-Pocket Health Expenditures in Mexico: a Model with an Endogoenous Treatment Variable," Health, Econometrics and Data Group (HEDG) Working Papers 08/12, HEDG, c/o Department of Economics, University of York.
    9. Claudia Rokx & George Schieber & Ajay Tandon & Pandu Harimurti & Aparnaa Somanathan, 2009. "Health Financing in Indonesia : A Reform Road Map," World Bank Publications - Books, The World Bank Group, number 2710.
    10. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    11. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    12. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    13. Menno Pradhan & Fadia Saadah & Robert Sparrow, 2007. "Did the Health Card Program Ensure Access to Medical Care for the Poor during Indonesia's Economic Crisis?," The World Bank Economic Review, World Bank, vol. 21(1), pages 125-150.
    14. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208, February.
    15. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    16. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health‐care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412, December.
    17. Menno Pradhan & Nicholas Prescott, 2002. "Social risk management options for medical care in Indonesia," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 431-446, July.
    18. Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," The World Bank Economic Review, World Bank, vol. 21(1), pages 93-123.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Asep Suryahadi & Robert Sparrow & Wenefrida Dwi Widyanti, "undated". "Asuransi Kesehatan Sosial untuk Masyarakat Miskin: Penargetan dan Dampak Program Askeskin di Indonesia," Working Papers 3450, Publications Department.
    2. Samarakoon, Shanika & Parinduri, Rasyad, 2015. "Social health insurance improves women’s healthcare use: Evidence from Indonesia," MPRA Paper 61504, University Library of Munich, Germany.
    3. Liu, Dan & Tsegai, Daniel W., 2011. "The New Cooperative Medical Scheme (NCMS) and its implications for access to health care and medical expenditure: Evidence from rural China," Discussion Papers 116746, University of Bonn, Center for Development Research (ZEF).
    4. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    5. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.
    6. Lim, Sung Soo, 2020. "Parental chronic illness and child education: Evidence from children in Indonesia," International Journal of Educational Development, Elsevier, vol. 73(C).
    7. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    8. Flores, Gabriela & O’Donnell, Owen, 2016. "Catastrophic medical expenditure risk," Journal of Health Economics, Elsevier, vol. 46(C), pages 1-15.
    9. Lau, Siew Yee & Parinduri, Rasyad & Lee, Yoong Hon, 2019. "Does Social Health Insurance Help Owners of Micro- and Small Firms Cope with Family Hardships? Evidence from Indonesia," MPRA Paper 95295, University Library of Munich, Germany.
    10. Ali, Shehzad & Cookson, Richard & Dusheiko, Mark, 2017. "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure," Social Science & Medicine, Elsevier, vol. 177(C), pages 127-140.
    11. Dhanaraj, Sowmya, 2014. "Health shocks and coping strategies: State health insurance scheme of Andhra Pradesh, India," WIDER Working Paper Series 003, World Institute for Development Economic Research (UNU-WIDER).
    12. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    13. Phuong Huu Khiem & Yu-Chen Kuo, 2022. "Health insurance reform impact on children’s educational attainment: evidence from Vietnam," Review of Economics of the Household, Springer, vol. 20(4), pages 1255-1285, December.
    14. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    15. repec:eid:wpaper:3/09 is not listed on IDEAS
    16. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    17. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    18. Ramses H. Abul Naga & Karine Lamiraud, 2008. "Catastrophic Health ExpenditureandHousehold Well-Being," STICERD - Distributional Analysis Research Programme Papers 098, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
    19. Kim, Younhee & Yang, Bongmin, 2011. "Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea," Health Policy, Elsevier, vol. 100(2), pages 239-246.
    20. Barnes, Kayleigh & Mukherji, Arnab & Mullen, Patrick & Sood, Neeraj, 2017. "Financial risk protection from social health insurance," Journal of Health Economics, Elsevier, vol. 55(C), pages 14-29.
    21. Meriem Oudmane & Fouzi Mourji & Abdeljaouad Ezzrari, 2019. "The impact of out‐of‐pocket health expenditure on household impoverishment: Evidence from Morocco," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1569-1585, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:264-271. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.