TY  - JOUR
AU  - Miller,Grant
AU  - Pinto,Diana M.
AU  - Vera-Hernández,Marcos
TI  - High-Powered Incentives in Developing Country Health Insurance: Evidence from Colombia’s Régimen Subsidiado
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 15456
PY  - 2009
Y2  - October 2009
UR  - http://www.nber.org/papers/w15456
L1  - http://www.nber.org/papers/w15456.pdf
N1  - Author contact info:
Grant Miller
CHP/PCOR
Stanford University
117 Encina Commons
Stanford, CA  94305-6019
Tel: 650/723-2714
Fax: 650/723-1919
E-Mail: ngmiller@stanford.edu

Diana M. Pinto
Department of Clinical Epidemiology
 and Biostatistics
Faculty of Medicine
Pontificia Universidad Javeriana
7th Avenue, #40-62, Second Floor
Bogotá, Colombia
Tel: 3208320 ext2804
E-Mail: dmpinto@gmail.com

Marcos Vera-Hernández
University College London
Department of  Economics
Gower St.
London WC1E 6BT
United Kingdom
E-Mail: m.vera@ucl.ac.uk
AB  - Despite current emphasis on health insurance expansions in developing countries, inefficient consumer incentives for over-use of medical care are an important counterbalancing concern. However, three factors that are more acute in poor countries (credit constraints, principal-agent problems, and positive externalities) result in substantial under-use and misuse as well. This paper studies Colombia’s Régimen Subsidiado, the first major developing country effort to expand insurance in a way that purposefully addresses these inefficiencies. Using a regression discontinuity design, we find that Colombia’s insurance program has provided risk protection while substantially increasing the use of traditionally under-utilized preventive services (with measurable health gains) through high-powered supply-side incentives.
ER  -