Open Access Te Herenga Waka-Victoria University of Wellington
thesis_access.pdf (3.59 MB)

The Impacts Of A Free Health Insurance Policy In Vietnam

Download (3.59 MB)
posted on 2021-12-09, 11:38 authored by Khoa Nguyen

Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.


Copyright Date


Date of Award



Victoria University of Wellington - Te Herenga Waka

Rights License

Author Retains Copyright

Degree Discipline

Public Policy

Degree Grantor

Te Herenga Waka—Victoria University of Wellington

Degree Level


Degree Name

Doctor of Philosophy

ANZSRC Type Of Activity code


Victoria University of Wellington Item Type

Awarded Doctoral Thesis



Alternative Language


Victoria University of Wellington School

School of Government


Desai, Jaikishan; Grimes, Arthur