Is there an ex-ante moral hazard on Indonesia's health insurance? An impact analysis on household waste management behavior

PLoS One. 2022 Dec 15;17(12):e0276521. doi: 10.1371/journal.pone.0276521. eCollection 2022.

Abstract

The presence of ex-ante moral hazard could undermine the potential gain from expanding health insurance coverage in developing nations. To test the proposition, this study utilizes a nationally representative longitudinal survey with Indonesia's health insurance for poor policy in 2014 as the quasi-experimental case study. The country represents developing nations that undergo a massive and rapid expansion of health insurance coverage. The empirical approach combines a matching and difference-in-differences method to obviate potential bias of the selectivity nature of health insurance provision and time-invariant unobserved factors. The findings suggest the presence of ex-ante moral hazard in the form of the less people using trash cans associated with the introduction of the subsidized health insurance premium. The results add empirical findings of a negative side effect of expanding health insurance coverage in developing nations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Health Behavior
  • Humans
  • Indonesia
  • Insurance, Health*
  • Morals
  • Waste Management*

Grants and funding

The authors are grateful for the support of the PUTI Grant by the Directorate of Research and Development, Universitas Indonesia (NKB-2043/UN2.RST/HKP.05.00/2020).