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3ie-LIDC Seminar Series - 'A Perverse 'Net' Effect? The impact of health insurance on use of insecticide treated nets (ITNs) in Ghana.'

Wednesday, March 14, 2012 - 17:30
Time: 5:30 - 7 PM
Venue: LIDC, 36 Gordon Square, Upper Meeting Room

Speaker: Thomas de Hoop, Evaluation officer 3ie, India

Discussant: Annette Brown, Deputy Director - Advancement and Impact Evaluation Services 3ie, Washington DC
Abstract:  “Incentive problems in insurance markets are well established in economic theory. One of these incentive problems is related to reduced prevention efforts following insurance coverage (ex-ante moral hazard). This prediction is yet to be tested empirically with regard to health insurance, as the health domain is often considered relatively immune to perverse incentives, despite its validation in other insurance markets that entail adverse health shocks. This paper tests for the presence of ex-ante moral hazard with reference to malaria prevention in Ghana. We investigate whether enrolment in the country’s National Health Insurance Scheme (NHIS) negatively affects ownership and use of insecticide-treated bed nets (ITNs). We use a panel of 400 households in the Brong Ahafo region for this purpose and employ a propensity-adjusted household fixed effects model. Our results provide evidence of ex-ante moral hazard especially when the level of effort and cost required for prevention is high. Different robustness checks as well as qualitative information from the surveyed communities support this finding. Implications of perverse incentive effects for the NHIS are briefly outlined.”
Thomas de Hoop is responsible for the review and quality control of impact evaluation research proposal. He also contributes to the development of the 3ie impact evaluation database. Thomas has obtained his PHD in development studies from the Radboud University in Nijmegen, The Netherlands. His current research focuses on the link between social norms and the effectiveness of development programs in Ghana, India and Peru. He has published papers in Social Science and Medicine, Nonprofit and Voluntary Sector Quarterly and the Developing Economies.
Annette Brown has more than fifteen years of research, technical assistance, project management, and business development experience in international development. Prior to joining 3ie, Annette served in several roles at Chemonics International Inc. including Director of Impact Measurement and Director of the Knowledge and Innovation Department. Before that, she directed the International Activities Center at the Urban Institute. Over the last decade, Annette has performed research and technical assistance work in more than twenty countries across Europe and Eurasia, the Middle East, and Asia.
Earlier in her career, Annette served as an Assistant Professor in the economics department at Western Michigan University, as a Research Associate at the Stockholm Institute of Transition Economics, and as an economist in the research department at the World Bank. She holds a Ph.D. in economics and a Masters in Russian and East European studies from the University of Michigan.