Do health vouchers broaden the choices of citizens with low socioeconomic status? An analysis of Medicaid in Brooklyn

ABSTRACT

Governments worldwide have committed to extending choices in public management to deliver services effectively; yet, how these programmes ensure equality remain unclear. This study investigated whether such programmes widened choices among different groups of citizens, focusing on Medicaid in Brooklyn, New York, in the 2000s. Information on patient admissions from the Statewide Planning Research and Cooperative System and hospitals from the American Hospital Association was analysed using a difference-in-difference-in-differences approach. Findings indicate that Medicaid programme failed to broaden the spatially confined choices of hospitals to patients with low socioeconomic status compared to non-Medicaid or uninsured groups.

KEYWORDS:

• Voucher
• choice of a provider
• inequality
• difference-in-difference-in-differences approach

Acknowledgments

The author would like to thank Professor Stephen Osborne, and the anonymous reviewers for their constructive and challenging comments, significantly improving the article. The author also thanks Professor Roh for his sharing abundant datasets and Jonathan Woolley for his research assistance. The earlier version of this article is available at https://doi.org/10.21203/rs.3.rs-144606/v1

Disclosure statement

No potential competing interest was reported by the authors.

Additional information

Notes on contributors

Jae Bok Lee

Jae Bok Lee is an Assistant Professor, Department of Public Administration, Gyeongsang National University, Republic of Korea. Her research interests include public management, equity and public policy, public service delivery, nonprofit organizations, and public finance.