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Health insurance as a state institution: The effect of single-payer insurance on expenditures in OECD countries

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  • Bichay, Nicolas

Abstract

A growing literature in comparative political economy and health economics has argued several cost-saving effects of a single-payer healthcare system. Despite this growing evidence, there has been no large-scale empirical examination of whether such an effect exists cross-nationally over time. This paper serves as the first attempt to find and calculate the extent to which healthcare spending is affected by the utilization of a single-payer scheme. I introduce an original dataset for OECD countries that measures when and where systems that qualify as single-payer exist, and employ it to test whether significant differences exist in health expenditures. Results demonstrate a significant difference between single- and multi-payer system expenditures. I estimate the utilization of a single-payer system is associated with decreased expenditure equal to 0.750 percentage-points of a nation's GDP. This would equate to the United States saving well over $1.5 trillion over ten years.

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  • Bichay, Nicolas, 2020. "Health insurance as a state institution: The effect of single-payer insurance on expenditures in OECD countries," Social Science & Medicine, Elsevier, vol. 265(C).
    • Handle: RePEc:eee:socmed:v:265:y:2020:i:c:s0277953620306730
    DOI: 10.1016/j.socscimed.2020.113454
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    References listed on IDEAS

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    4. Hussey, P. & Anderson, G. F., 2003. "A comparison of single- and multi-payer health insurance systems and options for reform," Health Policy, Elsevier, vol. 66(3), pages 215-228, December.
    5. Cutler, David M. & Pozen, Alexis, 2010. "Medical Spending Differences in the United States and Canada: The Role of Prices, Procedures, and Administrative Expenses," Scholarly Articles 5343032, Harvard University Department of Economics.
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    1. Jordan Alzubi & Derrick Fung & Charles Yang & Jason Yeh, 2022. "Improving health insurance markets: cost efficiency, implementation, and financing of expanding association health plans," Review of Quantitative Finance and Accounting, Springer, vol. 59(2), pages 671-694, August.

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