There is considerable ambiguity in the international literature on the effect of health insurance on health. While the majority of previous analyses have examined outcomes such as self-reported health, clinical indicators and mortality, analyses of the broader dimensions of health such as psychological health and wellbeing have been less frequent. Using data from the Irish Longitudinal Study on Ageing (TILDA) and a difference-in-differences research design, we examine the impact of free general practitioner (GP) care on psychological health among the older population and explore potential mechanisms. While we find no impact of health insurance expansions on quality of life, life satisfaction, depression, and worry, the removal of GP fees for all those 70 and above leads to a significantly lower level of perceived stress. Moreover, the impact is mainly driven by poorer, sicker and single individuals. Further analyses show that the removal of GP fees leads to greater access to GP services and lower levels of financial stress.

About the presenter

Dr Anne Nolan is an Associate Research Professor in the Social Research Division, and joint Research Area Coordinator for Health and Quality of Life Research at the ESRI. She is also a Research Affiliate at the Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin (TCD), and on the Study Team Management Group of the Growing up in Ireland (GUI) study. Between September 2013 and August 2015, she was on secondment to TCD as Research Director of TILDA. Her main research interest is health economics, with a particular focus on healthcare financing and access, socio-economic inequalities in health and Irish health policy.


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