HEALTH INSURANCE FOR THE POOR: IMPACT ASSESSMENT OF MOROCCO’S RAMed PLAN ON HEALTHCARE CONSUMPTION USING A HOUSEHOLD PANEL SURVEY DATA

Youness Jouilil, Houda Lechheb, Hicham Ouakil

Abstract


The general objective of this research paper is to evaluate the causal effect of RAMed medical insurance coverage on health care expenditures of poor and vulnerable families in Morocco. To do this, we used a longitudinal data from the second (2013) and third (2015) waves of the Household Panel Survey, which were produced by the National Observatory of Human Development. In this respect, we used the quasi-experimental technique called difference in difference to estimate the real impact of the RAMed medical scheme on health care expenditures. The econometric modelling shows that the impact of RAMed on health expenditure depends on the multi-faceted interactions between the diet and the characteristics of the patient. In addition, the results suggested that RAMed health coverage does not reduce the health costs of the poor families. In fact, after controlling for observable characteristics such as age, marital status, area of residence and standard of living, we found that the policy evaluated had a negative and statistically insignificant impact at the critical threshold 5% on the treaty group. That means, people who are covered by RAMed spend like those who not covered by any health insurance plan, even when are taking into account the characteristics of household. Hence, the implementation of the RAMed program has been associated with an increase in healthcare expenditure, particularly indirect expenses incurred by households (transport, accommodation costs, support costs, etc.). This supports the fact that poor and vulnerable Moroccan households contribute in financing of health care despite the State’s efforts made in order to ameliorate this regime. Therefore, the review of this scheme is necessary in order to ensure the sustainability of its services especially with regard to the flexibility of non-compliance with the pathway of care by patients especially for those who come from rural areas and the acceleration of the implementation of advanced regionalization, which will make it possible to have one hospital per region.

 

JEL: E20, E22, L60, L81

 

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impact assessment, RAMed health coverage, difference-in-differences, health care expenditures, household panel survey data

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References


Arrow, Kenneth J., (1963). «Uncertainty and the Welfare Economics of Medical Care», American Economic Review 53: p. 941-973.

Ashenfelter, O. (1978). «Estimating the Effect of Training Programs on Earnings», The Review of Economic and Statistics, 60, 1. p. 47-57.

Association Marocaine des Sciences Economiques (AMSE)., (2017), «Repenser la protection sociale au Maroc», Régime, Logique et Coût, 11eme congres.

Berman P. & Winnie Y., (2001). «Targeted health insurance in a low income country and its impact on access and equity in access: Egypt's school health insurance. Health Economics», Volume10, Issue3: p. 207-220.

Berkman, L. F., T. Glass, I. Brissette & T. E. Seeman (2000). «From social integration to health: Durkheim in the new millennium », Social Science and Medicine, 51,6 : p. 843-857.

Deborah Stone. (2008). «Protect the Sick: Health Insurance Reform in One Easy Lesson», Journal of Law, Medicine and Ethics.

Dror, D. & C. Jacquier. (1999). «Micro-Insurance: Extending Health Insurance to the Excluded», International Social Security Review, 52 (1), p. 71.

Gaag, G. E. (1990). «The Willingness to Pay for Medical Care: Evidence from Two Developing Countries», The Johns Hopkins University Press, Baltimore, MD.

Grossman M. (1972). «On the concept of health capital and the demand for health», Journal of Political Economy.

Jowett M., Deolalikar A. & Martinsson P. (2004). «Health insurance and treatment seeking behaviour: evidence from a low-income country», Health Economics. 13: 845–857.

La constitution du Royaume du Maroc. (2011). p. 9.

Manning, W., Newhouse, J., Duan, N., Keeler, E., Leibowitz, A. & Marquis, M., (1987). «Health insurance and the demand for medical care: evidence from a randomised experiment», American Economic Review 77,p. 251-277.

National Observatory of Human Development (NOHD) (2014) «Rapport d’activités 2014», p. 18-19.

Organisation de Coopération et de Développement Economiques (OCDE) (2012). «Toujours plus d’inégalité Pourquoi les écarts de revenus se creusent».

Puhani P. A. (2012). «The treatment effect, the cross difference, and the interaction term in nonlinear difference-in-differences models», Econ. Lett.115: p. 85–87.

R., Anderson (1978). «Health status indices and access to medical care», American Journal of Public Health 68.

Ruhm, J. C. (2012). «The Economics of Risky Health Behaviors. Handbook of Health Economics», Volume 2.

Solignac-Lecomte, H.-B. (2013). «L’Afrique est-elle vraiment bien partie ? », L’économie politique, 3(59).

Weinberger, K., Jütting, J. (2001). «Women’s participation in local organizations: conditions and constraints. In: World Development», Vol. 29, no. 8, pp 1391 - 1404.

Wooldridge, J. M. (2010). «Econometric Analysis of Cross Section and Panel Data», 2nd ed. Cambridge, MA: MIT Press.




DOI: http://dx.doi.org/10.46827/ejefr.v0i0.591

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