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Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland

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  • Lavaste, Konsta

Abstract

Voluntary private health insurance (VPHI) has gained popularity in universal public healthcare systems. We studied how the local provision of healthcare services correlated with VPHI take-up in Finland. Nationwide register data from a Finnish insurance company was aggregated to the local level and augmented with high-quality data on public and private primary care providers’ geographical closeness and fees. We found that the sociodemographic characteristics explained the VPHI take-up more than public or private healthcare provision. The VPHI take-up was negatively associated with distance to the nearest private clinic, while the associations with distance to public health stations were statistically weak. Fees and co-payments for healthcare services were not associated with insurance take-up, meaning that the geographical closeness of providers explained the take-up more than the price of services. On the other hand, we found that VPHI take-up was higher when local employment, income and education levels were higher.

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  • Lavaste, Konsta, 2023. "Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland," Health Policy, Elsevier, vol. 132(C).
    • Handle: RePEc:eee:hepoli:v:132:y:2023:i:c:s0168851023001057
    DOI: 10.1016/j.healthpol.2023.104820
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    1. Søgaard, Rikke & Pedersen, Morten Saaby & Bech, Mickael, 2013. "To what extent does employer-paid health insurance reduce the use of public hospitals?," Health Policy, Elsevier, vol. 113(1), pages 61-68.
    2. Aida Isabel Tavares, 2020. "Voluntary private health insurance demand determinants and risk preferences: Evidence from SHARE," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(3), pages 685-703, May.
    3. Martinussen, Pål E. & Magnussen, Jon, 2019. "Is having private health insurance associated with less support for public healthcare? Evidence from the Norwegian NHS," Health Policy, Elsevier, vol. 123(7), pages 675-680.
    4. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2011. "Waiting times for elective surgery and the decision to buy private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 68-86, September.
    5. Sara Moreira & Pedro Pita Barros, 2010. "Double health insurance coverage and health care utilisation: evidence from quantile regression," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1075-1092, September.
    6. Bíró, Anikó & Hellowell, Mark, 2016. "Public–private sector interactions and the demand for supplementary health insurance in the United Kingdom," Health Policy, Elsevier, vol. 120(7), pages 840-847.
    7. Marisol Rodríguez & Alexandrina Stoyanova, 2008. "Changes in the demand for private medical insurance following a shift in tax incentives," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 185-202, February.
    8. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    9. Daniele Fabbri & Chiara Monfardini, 2016. "Opt Out or Top Up? Voluntary Health Care Insurance and the Public vs. Private Substitution," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 78(1), pages 75-93, February.
    10. Jenni Blomgren & Lauri J Virta, 2020. "Socioeconomic differences in use of public, occupational and private health care: A register-linkage study of a working-age population in Finland," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-18, April.
    11. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    12. Carine Franc & Marc Perronnin & Aurélie Pierre, 2016. "Supplemental Health Insurance and Healthcare Consumption—A Dynamic Approach to Moral Hazard," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1582-1598, December.
    13. Mireia Jofre-Bonet, 2000. "Public health care and private insurance demand: The waiting time as a link," Health Care Management Science, Springer, vol. 3(1), pages 51-71, January.
    14. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    15. Karl Ove Aarbu, 2010. "Demand Patterns for Treatment Insurance in Norway," CESifo Working Paper Series 3021, CESifo.
    16. Propper, Carol & Rees, Hedley & Green, Katherine, 2001. "The Demand for Private Medical Insurance in the UK: A Cohort Analysis," Economic Journal, Royal Economic Society, vol. 111(471), pages 180-200, May.
    17. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    18. Tynkkynen, Liina-Kaisa & Alexandersen, Nina & Kaarbøe, Oddvar & Anell, Anders & Lehto, Juhani & Vrangbӕk, Karsten, 2018. "Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors," Health Policy, Elsevier, vol. 122(5), pages 485-492.
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