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Improving Takeup of Health Insurance Program: A Social Experiment in France

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  • Sophie Guthmuller
  • Florence Jusot
  • Jérôme Wittwer

Abstract

This paper is based on a randomized experiment conducted in order to understand the low takeup rate of a complementary health-insurance voucher program for the poorest in France. We explore two of the main hypotheses put forward to explain low enrollment: difficulties in accessing information about the program and a voucher amount considered to be too low. Results show that a voucher increase has a small but significant effect on takeup and the invitation to an information meeting discourages it. This study confirms the difficulties that are faced in increasing the healthinsurance coverage of poor populations via subsidy programs.

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  • Sophie Guthmuller & Florence Jusot & Jérôme Wittwer, 2014. "Improving Takeup of Health Insurance Program: A Social Experiment in France," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 167-194.
    • Handle: RePEc:uwp:jhriss:v:49:y:2014:i:1:p:167-194
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    14. Bago d'Uva, Teresa & Jones, Andrew M., 2009. "Health care utilisation in Europe: New evidence from the ECHP," Journal of Health Economics, Elsevier, vol. 28(2), pages 265-279, March.
    15. Anna Aizer, 2003. "Low Take-Up in Medicaid: Does Outreach Matter and for Whom?," American Economic Review, American Economic Association, vol. 93(2), pages 238-241, May.
    16. Dahlia K. Remler & Jason E. Rachlin & Sherry A. Glied, 2001. "What can the take-up of other programs teach us about how to improve take-up of health insurance programs?," NBER Working Papers 8185, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Arrighi, Y. & Rapp, T. & Sirven, N., 2017. "The impact of economic conditions on the disablement process: A Markov transition approach using SHARE data," Health Policy, Elsevier, vol. 121(7), pages 778-785.
    3. Rodolphe Durand & Marieke Huysentruyt, 2022. "Communication frames and beneficiary engagement in corporate social initiatives: Evidence from a randomized controlled trial in France," Strategic Management Journal, Wiley Blackwell, vol. 43(9), pages 1823-1853, September.
    4. Bakx, Pieter & Douven, Rudy & Schut, Frederik T., 2021. "Does independent needs assessment limit use of publicly financed long-term care?," Health Policy, Elsevier, vol. 125(1), pages 41-46.
    5. Per Engström & Eskil Forsell & Johannes Hagen & Arnaldur Stefánsson, 2019. "Increasing the take-up of the housing allowance among Swedish pensioners: a field experiment," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 26(6), pages 1353-1382, December.
    6. Pierre, Aurélie & Jusot, Florence, 2017. "The likely effects of employer-mandated complementary health insurance on health coverage in France," Health Policy, Elsevier, vol. 121(3), pages 321-328.
    7. Arrighi, Yves & Davin, Bérengère & Trannoy, Alain & Ventelou, Bruno, 2015. "The non-take up of long-term care benefit in France: A pecuniary motive?," Health Policy, Elsevier, vol. 119(10), pages 1338-1348.
    8. Joseph J. Capuno & Aleli D. Kraft & Stella Quimbo & Carlos R. Tan & Adam Wagstaff, 2016. "Effects of Price, Information, and Transactions Cost Interventions to Raise Voluntary Enrollment in a Social Health Insurance Scheme: A Randomized Experiment in the Philippines," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 650-662, June.
    9. Aurélie Pierre & Florence Jusot, 2015. "Une évaluation ex ante de la généralisation de la complémentaire santé d’entreprise sur les inégalités et les déterminants de la non-couverture," Working Papers DT67, IRDES institut for research and information in health economics, revised Jul 2015.
    10. Hagen, Johannes & Malisa, Amedeus, 2022. "Financial fraud and individual investment behavior," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 593-626.
    11. Nyman, Pär & Aggeborn, Linuz & Ahlskog, Rafael, 2023. "Filling in the blanks: How does information about the Swedish EITC affect labour supply?," Labour Economics, Elsevier, vol. 85(C).
    12. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327, CPB Netherlands Bureau for Economic Policy Analysis.
    13. Raf Van Gastel & Tim Goedemé & Julie Janssens & Eva Lefevere & Rik Lemkens, 2017. "A Reminder to Pay Less for Healthcare: take-up of Increased Reimbursement in a large-scale randomized field experiment," Working Papers 1712, Herman Deleeck Centre for Social Policy, University of Antwerp.
    14. Sophie Guthmuller & Jérôme Wittwer, 2017. "The Impact of the Eligibility Threshold of a French Means‐Tested Health Insurance Programme on Doctor Visits: A Regression Discontinuity Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 17-34, December.
    15. Adam Wagstaff & Ha Thi Hong Nguyen & Huyen Dao & Sarah Bales, 2016. "Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 663-674, June.
    16. Giles, John & Meng, Xin & Xue, Sen & Zhao, Guochang, 2021. "Can information influence the social insurance participation decision of China's rural migrants?," Journal of Development Economics, Elsevier, vol. 150(C).

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