Does health insurance increase health care utilization? evidence of ex-post moral hazard from the Social Security Scheme in Thailand

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ID: 314804
2026
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Abstract
Expanding health insurance improves access to care, but it may also increase healthcare utilization and fiscal pressure on public systems. Using multiple waves of the Thailand Socio-Economic Survey, this study applies a difference-in-differences (DD) approach combined with propensity score matching to estimate the causal effect of Social Security Scheme (SSS) coverage. The results show that insurance coverage increases healthcare utilization, consistent with behavioral responses associated with ex-post moral hazard, although part of this increase reflects improved access to necessary care. The magnitude of the effects varies across types of medical expenditures, estimation methods, and study periods. These findings highlight the importance of balancing expanded healthcare access with the financial sustainability of the SSS. Policymakers may consider targeted cost-management measures, efficiency improvements, and strengthened preventive health policies while maintaining equitable access to healthcare services.
Reference Key
openalex_W7162211245 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Aeggarchat Sirisankanan, Papar Kananurak, Theerathorn Yoongthong
Journal Health policy and planning
Year 2026
DOI
10.1093/heapol/czag072
URL
https://doi.org/10.1093/heapol/czag072
Keywords Keywords not found

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