カンボジアにおける小口健康保険と健康との相互関係

―リスク選好と時間選好を考慮に入れて―

抄録

The poor rural households in developing countries are vulnerable to the damage caused by unpredicted shock. The informal institutions created for risk coping cannot smooth unstable income of poor households completely. To smooth income of poor household, government of developing countries and aid agencies are trying to encourage those households to adopt micro-insurance.

However, the take-up rate of micro-insurance is still very low in most of the countries where the programs are introduced.

The objectives of this article are to investigate the determinants of purchasing micro-health insurance (SKY insurance) in Cambodia and the effects of the insurance on health condition of the household who purchased the insurance. For that purpose, we apply a treatment effect model, using the data which we collected in rural Cambodia. And we also estimate the treatment effect model, taking into consideration the impacts of risk and time preferences of households.

From our analysis, we find the following results. First, the purchase of SKY insurance does not have significant effects on the subjective indicators of household members' health. Second, the past experiences of illness and injury have significantly positive impacts on decision of purchase of SKY insurance only if the aged family members exist. Third, the larger the degree of risk aversion, household is less likely to purchase health insurance. These findings imply that the quality of medical services must be improved, and insurance scheme should be appropriate to match the demand of beneficiaries, in order to disseminate micro-health insurance in Cambodia.