Separating selection and incentive effects in health insurance

Details

Serval ID
serval:BIB_94F60482D344
Type
Report: a report published by a school or other institution, usually numbered within a series.
Publication sub-type
Working paper: Working papers contain results presented by the author. Working papers aim to stimulate discussions between scientists with interested parties, they can also be the basis to publish articles in specialized journals
Collection
Publications
Institution
Title
Separating selection and incentive effects in health insurance
Author(s)
Gardiol Lucien, Geoffard Pierre-Yves, Grandchamp Chantal
Publisher
PSE, Ecole Normale Supérieure
Institution details
Paris-Jourdan Sciences économiques
Address
Paris
Issued date
2005
Number
2005-38
Genre
Working paper
Language
english
Number of pages
44
Abstract
This paper provides an analysis of the health insurance and health care consumption. A structural microeconomic model of joint demand for health insurance and health care is developed and estimated using full maximum likelihood method using Swiss insurance claims data for over 60 000 adult individuals. The estimation strategy relies on the institutional features of the Swiss system, in which each individual chooses among the same menu of contracts, ranked by the size of their deductible. The empirical analysis shows strong and robust evidence of selection effects. Nevertheless, once selection effects are controlled for, an important incentive effect ("ex-post moral hazard") remains. A decrease in the copayment rate from 100% to 10% increases the marginal demand for health care by about 90% and from 100% to 0% by about 150%. The correlation between insurance coverage and health care expenditures may be decomposed into the two effects: 75% may be attributed to selection, and 25 % to incentive effects. [Authors]
Keywords
Insurance, Health , Health Services Needs and Demand
Create date
14/03/2008 11:12
Last modification date
20/08/2019 15:57
Usage data