Working Paper: NBER ID: w28972
Authors: Pascaline Dupas; Radhika Jain
Abstract: We document large gender disparities within a government program that entitles 46 million poor individuals to free hospital care. We show that care is not free in practice and higher costs are associated with larger disparities. Lowering care costs increases female utilization but does not reduce gender disparities because marginal beneficiaries are as likely to be male as inframarginals. Long-term exposure to local female leaders reduces disparities by addressing factors lowering female care. In the presence of gender bias, subsidizing social services may fail to address gender inequalities without actions that specifically target females.
Keywords: gender disparities; health insurance; India; government programs; healthcare utilization
JEL Codes: I12; I13; J16; O12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Higher out-of-pocket charges (G52) | Decrease in female share of BSBY visits (J21) |
| Greater distance to nearest hospital (I14) | Decrease in female share of BSBY visits (J21) |
| Increase in BSBY subsidy (H29) | Gender gap in hospital visits (I11) |
| Long-term exposure to female leaders (J16) | Increase in female share of BSBY visits among children and adults (J13) |
| Administrative reform in January 2018 (H83) | BSBY utilization (J13) |
| Reduction in distance to nearest private hospital (I14) | BSBY utilization (J13) |