IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v119y2015i5p688-695.html
   My bibliography  Save this article

How profitable is a voluntary deductible in health insurance for the consumer?

Author

Listed:
  • van Winssen, K.P.M.
  • van Kleef, R.C.
  • van de Ven, W.P.M.M.

Abstract

To counteract moral hazard in health insurance, insured can be offered a voluntary deductible (VD) in return for a premium rebate. In the Dutch mandatory basic health insurance however, only 11 per cent of the insured opted for a VD in 2014. Several determinants could affect the decision to opt for a VD. This paper examines one of these determinants: the financial profitability. A VD is profitable for the consumer if the out-of-pocket expenses do not exceed the offered premium rebate. The empirical analyses, based upon individual-level data on costs and characteristics of over 800,000 Dutch insured, show that a VD of €500 on top of the mandatory deductible of €360 would have been financially profitable for 48 per cent of the Dutch insured given the average premium rebate of € 240 in 2014. If the whole population had a VD, most insured would obtain either the maximum loss (44 per cent) or the maximum gain (41 per cent). A VD is profitable for males, young insured, healthy insured and insured with few healthcare expenses in the past. To further reduce moral hazard, the following strategies can be used to increase the number of insured opting for a VD: provide insured with information regarding the VD and introduce a shifted deductible.

Suggested Citation

  • van Winssen, K.P.M. & van Kleef, R.C. & van de Ven, W.P.M.M., 2015. "How profitable is a voluntary deductible in health insurance for the consumer?," Health Policy, Elsevier, vol. 119(5), pages 688-695.
  • Handle: RePEc:eee:hepoli:v:119:y:2015:i:5:p:688-695
    DOI: 10.1016/j.healthpol.2015.02.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851015000548
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2015.02.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. van Kleef, R.C. & van de Ven, W.P.M.M. & van Vliet, R.C.J.A., 2009. "Shifted deductibles for high risks: More effective in reducing moral hazard than traditional deductibles," Journal of Health Economics, Elsevier, vol. 28(1), pages 198-209, January.
    2. R. Kleef & K. Beck & W. Ven & R. Vliet, 2007. "Does risk equalization reduce the viability of voluntary deductibles?," International Journal of Health Economics and Management, Springer, vol. 7(1), pages 43-58, March.
    3. Daniel Kahneman & Amos Tversky, 2013. "Prospect Theory: An Analysis of Decision Under Risk," World Scientific Book Chapters, in: Leonard C MacLean & William T Ziemba (ed.), HANDBOOK OF THE FUNDAMENTALS OF FINANCIAL DECISION MAKING Part I, chapter 6, pages 99-127, World Scientific Publishing Co. Pte. Ltd..
    4. Samuelson, William & Zeckhauser, Richard, 1988. "Status Quo Bias in Decision Making," Journal of Risk and Uncertainty, Springer, vol. 1(1), pages 7-59, March.
    5. Johnson, Eric J & Hershey, John & Meszaros, Jacqueline & Kunreuther, Howard, 1993. "Framing, Probability Distortions, and Insurance Decisions," Journal of Risk and Uncertainty, Springer, vol. 7(1), pages 35-51, August.
    6. Janko Gorter & Paul Schilp, 2012. "Risk preferences over small stakes: Evidence from deductible choice," DNB Working Papers 338, Netherlands Central Bank, Research Department.
    7. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    8. Richard C. Van Kleef & Wynand P. M. M. Van De Ven & René C. J. A. Van Vliet, 2006. "A Voluntary Deductible in Social Health Insurance with Risk Equalization: “Community‐Rated or Risk‐Rated Premium Rebate?”," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 73(3), pages 529-550, September.
    9. Mosca, I. & Schut-Welkzijn, A., 2008. "Choice determinants of the mobility in the Dutch health insurance market," Other publications TiSEM 6908cbf8-9b72-47ff-98ee-3, Tilburg University, School of Economics and Management.
    10. Bakker, Frank M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2000. "Deductibles in health insurance: can the actuarially fair premium reduction exceed the deductible?," Health Policy, Elsevier, vol. 53(2), pages 123-141, September.
    11. Ilaria Mosca & Anoushka Schut-Welkzijn, 2008. "Choice determinants of the mobility in the Dutch health insurance market," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(3), pages 261-264, August.
    12. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    13. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    14. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    15. Eric French & John Bailey Jones, 2004. "On the distribution and dynamics of health care costs," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(6), pages 705-721.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rob J. M. Alessie & Viola Angelini & Jochen O. Mierau & Laura Viluma, 2020. "Moral hazard and selection for voluntary deductibles," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1251-1269, October.
    2. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2016. "Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1059-1072, December.
    3. M. Antonini & R. C. van Kleef & J. Henriquez & F. Paolucci, 2023. "Can risk rating increase the ability of voluntary deductibles to reduce moral hazard?," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 130-156, January.
    4. Fey, Jan-Christian & Schmeiser, Hato & Schreiber, Florian, 2024. "Optimal insurance deductibles under limited information," Journal of Economic Behavior & Organization, Elsevier, vol. 220(C), pages 202-221.
    5. Remmerswaal, Minke & Boone, Jan & Douven, Rudy, 2023. "Minimum generosity levels in a competitive health insurance market," Journal of Health Economics, Elsevier, vol. 90(C).
    6. Luke B. Connelly & Stephen Birch, 2020. "Sustainability of Publicly Funded Health Care Systems: What Does Behavioural Economics Offer?," PharmacoEconomics, Springer, vol. 38(12), pages 1289-1295, December.
    7. D. Cattel & R. C. Kleef & R. C. J. A. Vliet, 2017. "A method to simulate incentives for cost containment under various cost sharing designs: an application to a first-euro deductible and a doughnut hole," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 987-1000, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2017. "A voluntary deductible in health insurance: the more years you opt for it, the lower your premium?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 209-226, March.
    2. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2016. "Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1059-1072, December.
    3. M. Antonini & R. C. van Kleef & J. Henriquez & F. Paolucci, 2023. "Can risk rating increase the ability of voluntary deductibles to reduce moral hazard?," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 130-156, January.
    4. Klein, T.J.; & Salm, M.; & Upadhyay, S.;, 2024. "Patient cost-sharing and redistribution in health insurance," Health, Econometrics and Data Group (HEDG) Working Papers 24/15, HEDG, c/o Department of Economics, University of York.
    5. Miriam Krieger & Stefan Felder, 2013. "Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice," IJERPH, MDPI, vol. 10(6), pages 1-18, June.
    6. Klein, Tobias J. & Salm, Martin & Upadhyay, Suraj, 2024. "Patient Cost-Sharing and Redistribution in Health Insurance," IZA Discussion Papers 16778, Institute of Labor Economics (IZA).
    7. Stefano DellaVigna, 2009. "Psychology and Economics: Evidence from the Field," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 315-372, June.
    8. Jidong Zhou, 2011. "Reference Dependence and Market Competition," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 20(4), pages 1073-1097, December.
    9. Manel Baucells & Cristina Rata, 2006. "A Survey Study of Factors Influencing Risk-Taking Behavior in Real-World Decisions Under Uncertainty," Decision Analysis, INFORMS, vol. 3(3), pages 163-176, September.
    10. Kuhberger, Anton, 1998. "The Influence of Framing on Risky Decisions: A Meta-analysis," Organizational Behavior and Human Decision Processes, Elsevier, vol. 75(1), pages 23-55, July.
    11. Platteau, Jean-Philippe & Ugarte Ontiveros, Darwin, 2021. "Cognitive bias in insurance: Evidence from a health scheme in India," World Development, Elsevier, vol. 144(C).
    12. R. Kleef & K. Beck & W. Ven & R. Vliet, 2007. "Does risk equalization reduce the viability of voluntary deductibles?," International Journal of Health Economics and Management, Springer, vol. 7(1), pages 43-58, March.
    13. Minke Remmerswaal & Jan Boone & Michiel Bijlsma & Rudy Douven, 2017. "Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare," CPB Discussion Paper 367, CPB Netherlands Bureau for Economic Policy Analysis.
    14. Brigitte C. Madrian & Dennis F. Shea, 2001. "The Power of Suggestion: Inertia in 401(k) Participation and Savings Behavior," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(4), pages 1149-1187.
    15. Roee Teper, 2010. "Probabilistic Dominance and Status Quo Bias," Working Paper 5864, Department of Economics, University of Pittsburgh.
    16. Jean Philippe Platteau & Darwin Ugarte Ontiveros, 2013. "Understanding and Information Failures in Insurance: Evidence from India," Development Research Working Paper Series 07/2013, Institute for Advanced Development Studies.
    17. Shanley, James & Grossman, Philip J., 2007. "Paradise to parking lots: Creation versus maintenance of a public good," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 36(4), pages 523-536, August.
    18. Hayen, Arthur P. & Klein, Tobias J. & Salm, Martin, 2021. "Does the framing of patient cost-sharing incentives matter? the effects of deductibles vs. no-claim refunds," Journal of Health Economics, Elsevier, vol. 80(C).
    19. Platteau, Jean-Philippe & Ugarte Ontiveros, Darwin, 2017. "Cognitive Bias in Insurance: Evidence from India," CEPR Discussion Papers 12242, C.E.P.R. Discussion Papers.
    20. Remmerswaal, Minke & Boone, Jan & Bijlsma, Michiel & Douven, R.C.M.H., 2017. "Cost-Sharing Design Matters : A Comparison of the Rebate and Deductible in Healthcare," Discussion Paper 2017-049, Tilburg University, Center for Economic Research.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:119:y:2015:i:5:p:688-695. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.