Effect of the National Health Insurance Scheme on Healthcare Utilization and Out-of-Pocket Payment: Evidence from GLSS 7

Abstract The Ghana National Health Insurance Scheme (NHIS) was established in 2003, Act, 2003 (Act 650), but later replaced with the 2012 852) to get rid of then “cash and carry” system paying for healthcare. aim scheme reduce cost healthcare provision increase access This paper investigates effect on utilization out-of-pocket payment, from providers’ perspective. study uses data seventh round Living Standards Survey (GLSS 7) conducted 2016/2017 employs estimation method Propensity Score Matching (PSM). findings are that enrollment onto Ghana’s increases by 26% decreases payment 4%. However, about 48% population still not enrolled, citing various reasons. Even those who 30% had dropped out several identifies age, income, education, sex, location residence as main determinants enrolling NHIS. I show reduces Ghana. A number Ghanaians have either registered or stopped no money, need NHIS, confidence system’ Any policy invigorate public NHIS should be targeted at young, poor, less educated, males, rural dwellers.