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Can Health Insurance Boost Fertility? The Fertility Effect of National Health Insurance in Taiwan
National health insurance
Difference in differences
|Issue Date:||2018-07-19 17:30:21 (UTC+8)|
The implementation of Taiwanese National Health Insurance in 1995 affected almost every Taiwanese citizen’s healthcare options and coverage. Inclusion of low-cost prenatal and postnatal care, delivery services, and child healthcare coverage indicates the implicit pronatalism of NHI policy. Given the endogeneity of healthcare availability to childbearing decisions, this study uses the 1995 implementation of NHI to estimate the impact of national healthcare on Taiwanese fertility. We first approach this question using OLS regression to test for correlation between completed childbearing and an NHI dummy, among other demographic factors. In the second approach, difference-in-differences methodologies estimate the effect of 1995 NHI implementation on the treatment group of Taiwanese women and state-insured control group. Our data sources are the 1979-2016 waves of the Women’s Marriage, Fertility, and Employment Survey conducted by the Statistical Department of the Taiwanese Ministry of the Interior. We hypothesize that the 1995 NHI policy change increased the fertility of Taiwanese women around the cutoff date despite sub-replacement national fertility beginning in the 1980s. OLS analysis fails to show a positive correlation between NHI and women’s fertility in Taiwan, however. Further, DID estimations using a maternal age and a conception time both reject the hypothesis that lowered cost of childbearing through NHI stimulated Taiwanese fertility.
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