Do informal risk sharing networks crowd out public voluntary health insurance? Evidence from Vietnam

Abstract

Many governments in low-income countries have promoted voluntary health insurance schemes in recent years, with the principal aim of improving access to services amongst those working in the informal economy. Few attempts to understand demand for such schemes exist, particularly in light of the importance of informal social security arrangements for many households. A model of demand for health insurance is developed reflecting this context, and estimated using data from Vietnam. The results show that informal financial networks may crowd out government promoted health insurance. Implications for theory and policy are discussed.