The challenges of universal health insurance in developing countries: Experimental evidence from Indonesia's national health insurance

Abstract: 'To investigate barriers to universal health insurance in developing countries, we designed a randomised experiment involving about 6,000 households in Indonesia who are subject to a government health insurance program with a weakly enforced mandate. Time-limited subsidies increased enrollment and attracted lower-cost enrolees, in part by reducing the strategic timing of enrolment to correspond with health needs. Registration assistance also increased enrolment, but increased attempted enrolment much more, as over one-half of households who attempted to enrol did not successfully do so. These findings underscore how weak administrative capacity can create important challenges in developing countries for achieving widespread coverage.'

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