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Risk Protection, Service Use, and Health Outcomes under Colombia’s Health Insurance Program for the Poor

Publication Date: 
October 1, 2013

American Economic Journal: Applied Economics 5(4): 61-91, 2013 (with Diana Pinto and Marcos Vera-Hernández)

Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally underutilized preventive services—with measurable health gains.