Thursday, July 26, 2012

[EQ] Universal health care and informal labor markets : the case of Thailand

Universal health care and informal labor markets:
the case of Thailand

Wagstaff, Adam; Manachotphong, Wanwiphang
Policy Research working paper; no. WPS 6116 July 2012

The World Bank

Available online PDF file [38p.] at:

“……This paper explores the possibility that universal health coverage may inadvertently result in distorted labor market choices, with workers preferring informal employment over formal employment, leading to negative effects on investment and growth, as well as reduced protection against non-health risks and the income risks associated with ill health.

It explores this hypothesis in the context of the Thai universal coverage scheme, which was rolled out in four waves over a 12-month period starting in April 2001. It identifies the effects of universal coverage through the staggered rollout, and gains statistical power by using no less than 68 consecutive labor force surveys, each containing an average of 62,000 respondents.

The analysis finds that universal coverage appears to have encouraged employment especially among married women, to have reduced formal-sector employment among married men but not among other groups, and to have increased informal-sector employment especially among married women. The largest positive informal-sector employment effects are found in the agricultural sector…..”


The health effects of universal health care:
evidence from Thailand

Wagstaff, Adam; Manachotphong, Wanwiphang; 
Policy Research working paper ; no. WPS 6119 July 2012
The World Bank

Available online PDF [28p.] at:

“………This paper exploits the staggered rollout of Thailands universal health coverage scheme to estimate its impacts on whether individuals report themselves as being too ill to work. The statistical power comes from the fact that there is an average of 62,000 respondents in the labor force survey at each survey date and no less than 68 survey dates, most of which are just one month apart.

The analysis finds that universal coverage reduced the likelihood of people reporting themselves to be too sick to work: the authors estimate the effect to be -0.004 one year after universal coverage and -0.007 three years after. ‘

The estimated effects are much larger among those age 65 and over. Universal coverage had a much larger effect on health (about four times larger) than the Village Fund scheme, which provided free credit to rural households through a subsidized microcredit scheme and which was rolled out around the same time as universal coverage.  …”



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