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Does Abolishing User Fees Lead to Improved Health Status? Evidence From Post-Apartheid South Africa

  • 2012
  • Working Paper
Tanaka, Shinsuke

Abstract: Whether user fees for basic health services should be charged or abolished to the poor has recently been debated. This study examines the impact of removing user fees on child health status in South Africa. Our main innovation is to exploit plausibly exogenous variation in access to free healthcare, due to the fact that black Africans under apartheid could exercise little political power and residential choice. By com- paring health development across ex ante similar children, we find that free healthcare improved the health status of boys but not of girls. Falsification exercises suggest that the results are not driven by preexisting trends or unobserved changes.


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