Mandatory Universal Drug Plan, Access to Health Care and Health: Evidence from Quebec, Canada
Bibliographic record
Abstract
This study estimates the effects of a mandatory, universal prescription drug insurance program in a public health care system with free physician and hospital services. In 1997 all residents of the province of Quebec, Canada, were required by law to have drug insurance coverage. Under this program, all persons under age 65 who are eligible for a private plan are required to join that plan and the public prescription drug insurance plan covers all Quebecers who are not eligible for a private plan. Using the 1994 to 2003 data of the National Population Health Survey and a difference-in-differences approach, we find that the mandatory program significantly increases drug coverage among the general population. The policy also significantly increases medication use and general practitioner visits but has little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there is a significant improvement in the health status of less healthy individuals. Analysis by drug insurance status before the reform and presence of chronic condition reveals that the probability of taking any medication and visiting a general practitioner increases more among the previously uninsured and those with a chronic condition, and the universal drug program produces positive health gains among the chronically ill.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".