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Living Happily Ever After? The Effect of Taiwan’s National Health Insurance on the Happiness of the Elderly

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  • Shao-Hsun Keng
  • Shin-Yi Wu

Abstract

The implementation of Taiwan’s National Health Insurance (NHI) in 1995 has created a quasi-experiment that permits us to draw causal inference for the effect of the NHI on the happiness and life satisfaction. The NHI is expected to have a positive effect on happiness because it not only improves the health and mitigates the uncertainty in financial losses due to health shocks, but also alleviates health inequality in the population through equal access to care. The results show that the NHI has a significant effect on happiness and life satisfaction. The effect ranges from 3 to 30 % depending on the measures of happiness. Nonetheless, the effect of the NHI in narrowing happiness inequality across socioeconomic status (SES) is significant for health and income groups only while its effect on education- and gender-happiness gradients are insignificant. The increase in the probability of being happy or satisfied with life among the least healthy group is 0.08 % points higher than that of the healthier ones. Earlier studies have shown that the effects of health insurance on health and disparity in health across SES groups are small. In contrast, our findings suggest that the welfare impact of the NHI is quite large. Copyright Springer Science+Business Media Dordrecht 2014

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  • Shao-Hsun Keng & Shin-Yi Wu, 2014. "Living Happily Ever After? The Effect of Taiwan’s National Health Insurance on the Happiness of the Elderly," Journal of Happiness Studies, Springer, vol. 15(4), pages 783-808, August.
    • Handle: RePEc:spr:jhappi:v:15:y:2014:i:4:p:783-808
    DOI: 10.1007/s10902-013-9449-4
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    1. repec:bla:etrans:v:15:y:2007:i::p:707-731 is not listed on IDEAS
    2. Gregori Baetschmann & Kevin E. Staub & Rainer Winkelmann, 2015. "Consistent estimation of the fixed effects ordered logit model," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 178(3), pages 685-703, June.
    3. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    4. Weili Ding & Steven F. Lehrer, 2010. "Estimating Treatment Effects from Contaminated Multiperiod Education Experiments: The Dynamic Impacts of Class Size Reductions," The Review of Economics and Statistics, MIT Press, vol. 92(1), pages 31-42, February.
    5. Clark, Andrew E & Oswald, Andrew J, 1994. "Unhappiness and Unemployment," Economic Journal, Royal Economic Society, vol. 104(424), pages 648-659, May.
    6. Sergei Guriev & Ekaterina Zhuravskaya, 2009. "(Un)happiness in Transition," Journal of Economic Perspectives, American Economic Association, vol. 23(2), pages 143-168, Spring.
    7. Erzo F. P. Luttmer, 2005. "Neighbors as Negatives: Relative Earnings and Well-Being," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(3), pages 963-1002.
    8. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March.
    9. Ceema Namazie & Peter Sanfey, 2001. "Happiness and Transition: the Case of Kyrgyzstan," Review of Development Economics, Wiley Blackwell, vol. 5(3), pages 392-405, October.
    10. Blundell, Richard & Macurdy, Thomas, 1999. "Labor supply: A review of alternative approaches," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 27, pages 1559-1695, Elsevier.
    11. Alesina, Alberto & Di Tella, Rafael & MacCulloch, Robert, 2004. "Inequality and happiness: are Europeans and Americans different?," Journal of Public Economics, Elsevier, vol. 88(9-10), pages 2009-2042, August.
    12. William Greene, 2004. "The behaviour of the maximum likelihood estimator of limited dependent variable models in the presence of fixed effects," Econometrics Journal, Royal Economic Society, vol. 7(1), pages 98-119, June.
    13. Chou, Y. J. & Staiger, Douglas, 2001. "Health insurance and female labor supply in Taiwan," Journal of Health Economics, Elsevier, vol. 20(2), pages 187-211, March.
    14. Marco Francesconi & Wilbert van der Klaauw, 2007. "The Socioeconomic Consequences of "In-Work" Benefit Reform for British Lone Mothers," Journal of Human Resources, University of Wisconsin Press, vol. 42(1).
    15. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    16. Lelkes, Orsolya, 2006. "Tasting freedom: Happiness, religion and economic transition," Journal of Economic Behavior & Organization, Elsevier, vol. 59(2), pages 173-194, February.
    17. Andrew E. Clark & Paul Frijters & Michael A. Shields, 2008. "Relative Income, Happiness, and Utility: An Explanation for the Easterlin Paradox and Other Puzzles," Journal of Economic Literature, American Economic Association, vol. 46(1), pages 95-144, March.
    18. David G. Blanchflower & Richard B. Freeman, 1997. "The Attitudinal Legacy of Communist Labor Relations," ILR Review, Cornell University, ILR School, vol. 50(3), pages 438-459, April.
    19. Di Tella, Rafael & Haisken-De New, John & MacCulloch, Robert, 2010. "Happiness adaptation to income and to status in an individual panel," Journal of Economic Behavior & Organization, Elsevier, vol. 76(3), pages 834-852, December.
    20. Becketti, Sean & Gould, William & Lillard, Lee & Welch, Finis, 1988. "The Panel Study of Income Dynamics after Fourteen Years: An Evaluatio n," Journal of Labor Economics, University of Chicago Press, vol. 6(4), pages 472-492, October.
    21. Shin-Yi Chou & Jin-Tan Liu & James Hammitt, 2006. "Households’ precautionary behaviors—the effects of the introduction of National Health Insurance in Taiwan," Review of Economics of the Household, Springer, vol. 4(4), pages 395-421, December.
    22. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 597-636.
    23. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    24. Carol Graham & Lucas Higuera & Eduardo Lora, 2011. "Which health conditions cause the most unhappiness?," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1431-1447, December.
    25. repec:bla:scandj:v:97:y:1995:i:4:p:603-20 is not listed on IDEAS
    26. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    27. Hayo, Bernd, 2007. "Happiness in transition: An empirical study on Eastern Europe," Economic Systems, Elsevier, vol. 31(2), pages 204-221, June.
    28. Dolan, Paul & Peasgood, Tessa & White, Mathew, 2008. "Do we really know what makes us happy A review of the economic literature on the factors associated with subjective well-being," Journal of Economic Psychology, Elsevier, vol. 29(1), pages 94-122, February.
    29. Kornai Janos, 1994. "Transformational Recession: The Main Causes," Journal of Comparative Economics, Elsevier, vol. 19(1), pages 39-63, August.
    30. Blanchflower, David G. & Oswald, Andrew J., 2004. "Well-being over time in Britain and the USA," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1359-1386, July.
    31. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    32. Robert J. MacCulloch & Rafael Di Tella & Andrew J. Oswald, 2001. "Preferences over Inflation and Unemployment: Evidence from Surveys of Happiness," American Economic Review, American Economic Association, vol. 91(1), pages 335-341, March.
    33. Sandra L. Decker, 2005. "Medicare and the Health of Women with Breast Cancer," Journal of Human Resources, University of Wisconsin Press, vol. 40(4), pages 948-968.
    34. Janet Currie & Mark Stabile, 2003. "Socioeconomic Status and Child Health: Why Is the Relationship Stronger for Older Children?," American Economic Review, American Economic Association, vol. 93(5), pages 1813-1823, December.
    35. Cornelissen, Thomas & Sonderhof, Katja, 2008. "Marginal effects in the probit model with a triple dummy variable interaction term," Hannover Economic Papers (HEP) dp-386, Leibniz Universität Hannover, Wirtschaftswissenschaftliche Fakultät.
    36. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    37. Kamhon Kan & Yen-Ling Lin, 2009. "The labor market effects of national health insurance: evidence from Taiwan," Journal of Population Economics, Springer;European Society for Population Economics, vol. 22(2), pages 311-350, April.
    38. Goldsmith, Arthur H. & Veum, Jonathan R. & Darity, William Jr., 1996. "The psychological impact of unemployment and joblessness," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 25(3), pages 333-358.
    39. Carol Graham & Andrew Felton, 2006. "Inequality and happiness: Insights from Latin America," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 4(1), pages 107-122, April.
    40. Justin Wolfers, 2003. "Is Business Cycle Volatility Costly? Evidence from Surveys of Subjective Well‐Being," International Finance, Wiley Blackwell, vol. 6(1), pages 1-26, March.
    41. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
    42. Liliana Winkelmann & Rainer Winkelmann, 1998. "Why Are the Unemployed So Unhappy?Evidence from Panel Data," Economica, London School of Economics and Political Science, vol. 65(257), pages 1-15, February.
    43. Ruut Veenhoven, 1999. "Quality-of-Life in Individualistic Society," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 48(2), pages 159-188, October.
    44. Mariano Rojas, 2004. "Well-being and the Complexity of Poverty: A Subjective Well-being Approach," WIDER Working Paper Series RP2004-29, World Institute for Development Economic Research (UNU-WIDER).
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    5. Sergei Guriev & Ekaterina Zhuravskaya, 2009. "(Un)happiness in Transition," Journal of Economic Perspectives, American Economic Association, vol. 23(2), pages 143-168, Spring.
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