The impact of National Health Insurance program on household consumption patterns in Taiwan

• Main Authors: Ching-Hsing Chang, 張景興
• Other Authors: Jui-Fen Rachel Lu
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/53232528116555081357

碩士 === 長庚大學 === 醫務管理學研究所 === 95 === Before the introduction of National Health Insurance (NHI) in 1995, there was about 43% of the population without any form of social insurance in Taiwan. About 57% of the population was insured through three major social insurance programs, namely Government Employee Insurance (GEI), Labor Insurance and Farmers' Insurance. Most of those without any form of social insurance were the elderly, the frail, women, children and people who have no working ability. Among the three major social insurance programs aforementioned, only GEI extended coverage to spouse and dependents. As NHI program was introduced on a compulsory basis, those who were not covered by any social insurance program before 1995 became insured starting in March 1995. This study is set forth to evaluate the impact of Taiwan's NHI on household consumption patterns. This study uses data from 1994-2005 DGBAS Surveys of Family Income and Expenditure (SFIE) and adopts a “difference-in-differences” (DID) estimation model. The major advantage of the DID model is to exclude the effect of natural growth over the years. In this study, control group is defined as any household member who can be identified as insured by GEI and those without any kind of social insurance are taken into treatment group. This study intends to examine the changes in household consumption patterns among household out-of-pocket health care payment, non-medical expenditures and savings through this exercise of the natural experiment. The empirical results are summarized as follows: first, a decrease of 20.9-27.5% in the household out-of-pocket health care payment share (defined as a proportion of the household disposable income) was observed after the implementation of NHI. The quantile regression results suggested that NHI has the largest negative effect on household out-of-pocket health care payment share at the top quantile, and the effects attenuated in the lower quantile；second, a decrease of 10.0-18.8% in the household savings share (defined as a proportion of household disposable income) was detected after the implementation of NHI. The quantile regression results suggested that NHI has the largest negative effect on household savings share at the bottom quantile, and the effects weakened in the higher quantile；third, an increase of 3.0-6.9% in the household non-medical expenditures share (defined as a proportion of household disposable income) was observed after the implementation of NHI, especially for the payment for necessities (such as food expenditures, rent and water charges and fuel and lighting expenditures). The quantile regression results further showed that NHI has the largest positive effect on household non-medical expenditures share at the bottom quantile, and the effects weakened in the higher quantile. In summary, it is observed that NHI program has significantly impacted on the household consumption patterns in Taiwan.