Document Type



Doctor of Philosophy (PhD)



First Advisor's Name

Hakan Yilmazkuday

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Sheng Guo

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Ronald Mesia

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Tobias Pfutze

Fourth Advisor's Committee Title

Committee Member


Economics, Catastrophic Health Care Expenditure, Health Economics, Welfare, Public Policy, International Economics, International Finance, Exchange Rate Pass-through

Date of Defense



Both economists and policy makers are interested in understanding the welfare effect of economic policies, especially in small open economies such as Turkey and Iran. This knowledge is crucial for priority setting in any informed policy discussion. This dissertation aims to study the impoverishing effect of high levels of out-of-pocket (OOP) payments in the health sector, referred to as catastrophic health expenditure (CHE), and investigates the impact of exchange rate pass-through (ERPT) on both the microeconomic and macroeconomic indicators of a country. For millions of people worldwide, health payments present a huge financial risk. A high rate of OOP health care payments can lead to CHE, which can force households to cut down their consumption, minimize access to their needs, or face poverty. This makes the design of financial risk protection necessary for governments in order to secure people against the financial hardship at the time of incurring CHE. This thesis comprises three essays. The first investigates financial risk protection indicators related to OOP health care payments through CHE mean positive overshoot and incidence and depth of impoverishment. This research observes that in the absence of universal health care insurance in Iran, together with a high share of OOP spending for health care (more than 52%), the Iranian households facing CHE will eventually face poverty. In the second essay, using a difference-in-differences propensity score matching approach, I seek to analyze the degree to which Iranian universal health care insurance protects households from high rates of OOP health expenditure. In this study, I evaluate the effect of the universal health insurance program on Iranian CHE. The results show that the program was successful in decreasing the rate of OOP health expenditures and CHE in Iran during the sample period. The third essay estimates the ERPT using product-level daily data on wholesale prices of imported agricultural products, where the identification is possible by using daily data on the domestic inflation rate. The results of standard empirical analyses are in line with existing studies that employ lower frequencies of data by showing evidence for incomplete daily ERPT of about 5 percent.



Included in

Economics Commons



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