title: Mandatory universal drug plan, access to health care and health: Evidence from Canada.
abstract: This paper examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Using the Canadian National Population Health Survey from 1994 to 2003 and implementing a difference-in-differences estimation strategy, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition.
authors.affiliation: International School of Economics and Management, Capital University of Economics and Business, Beijing 100070, PR China. Electronic address: sarahchaowang@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: International School of Economics and Management, Capital University of Economics and Business, Beijing 100070, PR China. Electronic address: liqing_cueb@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Economics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4M4; Centre for Health Economics and Policy (CHEPA), McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1. Electronic address: arthur.sweetman@mcmaster.ca.
authors.forename: Arthur
authors.initials: A
authors.lastname: Sweetman
authors.affiliation: Department of Economics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4M4; Centre for Health Economics and Policy (CHEPA), McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1. Electronic address: hurley@mcmaster.ca.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Hurley
mesh_terms: D002170:Canada; D002908:Chronic Disease / Q000188:drug therapy / Q000191:economics*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000331:legislation & jurisprudence*; D008137:Longitudinal Studies; D037141:Mandatory Programs; D017063:Outcome Assessment, Health Care; D011634:Public Health / Q000191:economics / Q000331:legislation & jurisprudence* / Q000639:trends; D011792:Quebec; D013219:State Government; D019472:Universal Health Insurance / Q000331:legislation & jurisprudence*; D016903:Drug Monitoring
keywords: Drug utilization; Health care utilization; Health status; Physician visits; Universal drug insurance