Many governments who have large public health care systems are looking
for means to reduce the public's financial burden. One approach is to
increase reliance on private health care delivery through expanded pr
ivate insurance coverage. Using data from Jamaica, we estimate models
of the demand for medical care. We find that insurance does induce ind
ividuals to opt out of the public sector in favor of the higher-qualit
y private sector, thereby reducing total public expenditures on health
care. Moreover, since insurance is concentrated among the upper incom
e groups, expanded insurance coverage better targets public expenditur
es to the poor.