Health Insurance, Health Status, Health Inequality, and Mortality: Evidence from Indonesia

Most previous studies regarding the effect of health insurance on health outcome have relied upon data from developed countries or specific population group, such as elderly and child. The geographic variation in the extent of the insurance expansion in Indonesia provides an excellent context to explore the causal impact of expanding public health insurance on health status of general population in a developing country. This research will cope with this issue by the following three dimensions. Firstly, this study uses the individual level data (Indonesia Family Life Survey) to explore whether having health insurance improves wide-spectrum measures of health status, such as self-rated general health status (GHS), symptoms, Instrumental Activities of Daily Living (IADL), and short CES-D scale regarding mental health. Secondly, by combing the data sets from Intercensal Population Survey, National Social-Economic Survey, and Village Potential Statistics, both the individual- and regency/city-level data was used to examine the impact of expanding health insurance on mortality rates in Indonesia. Thirdly, this study uses concentration index to provide descriptive analysis regarding the income (wealth) / education-related inequality in health status (mortality) before and after implementing the national health insurance program. In order to deal with the self-selection issues, this study will use the quasi-experimental approach - difference-in-difference (DID) method with propensity score matching (PSM) and instrumental variable (IV) method to estimate the health insurance effect.