User fee abolition and the demand for public health care

Abstract

This research examines the effect of the abolition of user fees in South Africa, a policy implemented in 1994 for uninsured children under the age of six and the elderly uninsured, as well as pregnant and nursing mothers. The analysis focuses on the implementation of the policy and the use of curative public healthcare services by children following strict and fuzzy regression discontinuity designs. The estimates point to statistically insignificant average and local average policy effects, even though the policy appears to have been implemented reasonably effectively, albeit imperfectly. In other words, the policy did not, on average, affect the use of curative public healthcare, at least for those children who should have benefited from the policy.