An evaluation of the Mexican Seguro Popular program (designed to extend health insurance and regular and preventive medical care, pharmaceuticals, and health facilities to 50 million uninsured Mexicans), one of the world's largest health policy reforms of the last two decades. Our evaluation features a new design for field experiments that is more robust to the political interventions and implementation errors that have ruined many similar previous efforts; new statistical methods that produce more reliable and efficient results using fewer resources, assumptions, and data; and an implementation of these methods in the largest randomized health policy experiment to date. (See the Harvard Gazette story on this project.)
1. The evaluation design: . 2007. “A "Politically Robust" Experimental Design for Public Policy Evaluation, with Application to the Mexican Universal Health Insurance Program,” Journal of Policy Analysis and Management, 26: 479-506.Abstract
We develop an approach to conducting large scale randomized public policy experiments intended to be more robust to the political interventions that have ruined some or all parts of many similar previous efforts. Our proposed design is insulated from selection bias in some circumstances even if we lose observations and our inferences can still be unbiased even if politics disrupts any two of the three steps in our analytical procedures and and other empirical checks are available to validate the overall design. We illustrate with a design and empirical validation of an evaluation of the Mexican Seguro Popular de Salud (Universal Health Insurance) program we are conducting. Seguro Popular, which is intended to grow to provide medical care, drugs, preventative services, and financial health protection to the 50 million Mexicans without health insurance, is one of the largest health reforms of any country in the last two decades. The evaluation is also large scale, constituting one of the largest policy experiments to date and what may be the largest randomized health policy experiment ever.