DEGREES OF INSURANCE AND FINANCIAL PROTECTION

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Health insurance reform is of utmost concern for countries that have relied on out-of-pocket payments to finance health treatment. To fully illuminate the effects of health costs on flourishing, we examined all health treatment and treatment associated costs among insured, under-insured and uninsured populations.

Our findings indicate that for inpatient treatment, compared with uninsured treatments, insured treatments showed significant decreases in total health costs for all households, with the most substantial decrease in poor households.  Our findings were similar for outpatient treatment, for which total costs decreased among the insured who used insurance compared with the uninsured, for all poverty levels. Poor households again had the largest savings. In examining specific types of insurance, Health Care Fund for the Poor (HCFP) appeared to yield the greatest decrease in total out- of-pocket payments for inpatient treatment among the different types of insurance. Most of this decrease came from a reduction in direct medical facility costs. Every other category of cost also decreased except for gifts (made to people escorting patients to a health facility and to caretakers within a facility), in which there was a slight increase.

In sum, we found that insurance reforms reduced the vulnerability of rural households to high costs and increased their security, particularly through direct reduction of income lost to illness. However, out-of-pocket costs were still too high and accessibility issues persist.

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