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The impact of health insurance programs on out-of-pocket expenditures in Indonesia: an increase or a decrease?
Budi Aji1, Manuela De Allegri, Aurelia Souares
1Institute of Public Health, Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg 69120, Germany. Aji@stud.uni-heidelberg.de
Summary
Indonesian health insurance programs, Askeskin and Askes, significantly reduced household out-of-pocket spending. These findings highlight the financial protection offered by effective health insurance benefit packages and co-payment policies.
Area of Science:
- Health Economics
- Public Health Policy
- Econometrics
Background:
- High out-of-pocket expenditures pose a significant financial burden on households in Indonesia.
- Understanding the impact of health insurance is crucial for designing effective financial protection strategies.
Purpose of the Study:
- To investigate the effect of Indonesian health insurance programs on household out-of-pocket expenditures.
- To assess the efficacy of Askeskin, Askes, and Jamsostek in reducing healthcare costs.
Main Methods:
- Utilized panel data from the Indonesian Family Life Survey.
- Employed three linear panel data models: pooled Ordinary Least Squares (OLS), pooled Two-Stage Least Squares (2SLS) with instrumental variables (IV), and Fixed Effects (FE).
- Accounted for endogeneity in the analysis.
Main Results:
- Instrumental variable (IV) estimates showed Askeskin reduced expenditures by 34% and Askes by 55%.
- The Fixed Effects (FE) model indicated Askeskin decreased expenditures by 11%.
- Jamsostek exhibited a non-significant effect on out-of-pocket expenditures in the IV model.
Conclusions:
- Askeskin and Askes are effective in reducing household out-of-pocket expenditures in Indonesia.
- The effectiveness of health insurance in providing financial protection is linked to benefit packages and co-payment structures.
- Policy implications for optimizing health insurance design to enhance financial protection.
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