The impact of National Health Insurance on birth outcomes: A natural experiment in Taiwan

We estimate the impacts of the introduction of National Health Insurance in Taiwan in March 1995 on infant survival. Prior to NHI, government workers (the control group) possessed health insurance policies with comprehensive coverage for births and infant medical care services. Private sector industrial workers and farmers (the treatment groups) lacked this coverage. All households received coverage in 1995. Since stringent requirements for reporting births introduced in 1994 produced artificial upward trends in early infant deaths, we focus on post-neonatal mortality. The introduction of NHI led to reductions in this rate for infants born in farm households but not for infants born in private sector households. For the former group, the rate fell by between 0.3 and 0.6 deaths per thousand survivors or by between 8 and 16%. A large decline of between 3.4 and 6.8 deaths occurred for pre-term infants a drop of between 20 and 41%. (C) 2014 Elsevier B.V. All rights reserved.