Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/111748
Authors: 
Neelsen, Sven
Limwattananon, Supon
O'Donnell, Owen
van Doorslaer, Eddy
Year of Publication: 
2015
Series/Report no.: 
Tinbergen Institute Discussion Paper 15-060/V
Abstract: 
We examine economic vulnerability to illness when, as for informal sector workers in Thailand, there is universal coverage for health care but earnings losses are uninsured. Even with comprehensive health care entitlement, severe illness that strikes an initially healthy worker is found to raise out-of-pocket medical expenses by around two thirds and increase the probability that medical spending absorbs more than a tenth of the household budget by nine percentage points. Moreover, severe illness reduces the probability of remaining in employment by 18 points and precipitates a reduction in household labor income of almost one third. Despite the rise in medical expenses and fall in earnings, households are able to maintain expenditure on goods and services other than medical care by drawing on remittances and informal transfers, cutting back on saving, and by borrowing. In the short term, informal insurance fills gaps left uncovered by formal insurance but there is likely to be subst antial exposure to economic risks associated with long-term illness.
Subjects: 
Health
medical expenditure
social insurance
universal coverage
Thailand
JEL: 
I13
J46
O12
Document Type: 
Working Paper

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