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Delivering Public Health Care Services: Substitutes, Complements, or Both?

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  • Kimberly J. Rask
  • Kevin N. Rask

Abstract

In this article we investigate how the availability of public health care providers increases (complement) or decreases (substitute) the likelihood of having public or private health insurance. The probability of each of three insurance alternatives (uninsured, Medicaid, private insurance) is modeled as a function of the availability of public programs in the respondents’community along with individual characteristics including family income, health status, and family structure. Using population‐based estimates, public hospitals are associated with a crowd‐out rate of 3.5 percent to 8.6 percent. Federally qualified health centers were associated with a net complementary effect (additional public insurance take‐up) of 7.1 percent. (JEL I11, I18, I38)

Suggested Citation

  • Kimberly J. Rask & Kevin N. Rask, 2005. "Delivering Public Health Care Services: Substitutes, Complements, or Both?," Contemporary Economic Policy, Western Economic Association International, vol. 23(1), pages 28-39, January.
    • Handle: RePEc:bla:coecpo:v:23:y:2005:i:1:p:28-39
    DOI: 10.1093/cep/byi003
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    References listed on IDEAS

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    1. Rask, Kevin N. & Rask, Kimberly J., 2000. "Public insurance substituting for private insurance: new evidence regarding public hospitals, uncompensated care funds, and medicaid," Journal of Health Economics, Elsevier, vol. 19(1), pages 1-31, January.
    2. Small, Kenneth A & Hsiao, Cheng, 1985. "Multinomial Logit Specification Tests," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 26(3), pages 619-627, October.
    3. Alan C. Monheit & Jessica Primoff Vistnes, 1999. "Health Insurance Availability at the Workplace: How Important are Worker Preferences?," Journal of Human Resources, University of Wisconsin Press, vol. 34(4), pages 770-785.
    4. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    5. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
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    Cited by:

    1. Radhika Lahiri & Elizabeth Richardson, 2008. "Public and Private Expenditures on Health in the Presence of Inequality and Endogenous Mortality: A Political Economy Perspective," School of Economics and Finance Discussion Papers and Working Papers Series 240, School of Economics and Finance, Queensland University of Technology, revised 15 Dec 2008.

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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