IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v15y2015i2p269-280.html
   My bibliography  Save this article

Physicians’ balance billing, supplemental insurance and access to health care

Author

Listed:
  • Izabela Jelovac

Abstract

Some countries allow physicians to balance bill patients, that is, to bill a fee above the one that is negotiated with, and reimbursed by the health authorities. Balance billing is known for restricting access to physicians’ services while supplemental insurance against balance billing amounts is supposed to alleviate the access problem. This paper analyzes in a theoretical setting the consequences of balance billing on the fees setting and on the inequality of access among the users of physicians’ services. It also shows that supplemental insurance against the expenses associated with balance billing, rather than alleviating the access problem, increases it. Copyright Springer Science+Business Media New York 2015

Suggested Citation

  • Izabela Jelovac, 2015. "Physicians’ balance billing, supplemental insurance and access to health care," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 269-280, June.
    • Handle: RePEc:kap:ijhcfe:v:15:y:2015:i:2:p:269-280
    DOI: 10.1007/s10754-015-9162-4
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10754-015-9162-4
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10754-015-9162-4?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 look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
    2. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier‐induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471, July.
    3. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687, July.
    4. Yaari, Menahem E, 1987. "The Dual Theory of Choice under Risk," Econometrica, Econometric Society, vol. 55(1), pages 95-115, January.
    5. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395, April.
    6. Mathias Kifmann & Florian Scheuer, 2011. "Balance billing: the patients' perspective," Health Economics Review, Springer, vol. 1(1), pages 1-14, December.
    7. Eichner, Matthew J, 1998. "The Demand for Medical Care: What People Pay Does Matter," American Economic Review, American Economic Association, vol. 88(2), pages 117-121, May.
    8. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    9. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
    10. Barros, Pedro Pita & Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2008. "Moral hazard and the demand for health services: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 27(4), pages 1006-1025, July.
    11. R. G. Beck, 1974. "The Effects of Co-Payment on the Poor," Journal of Human Resources, University of Wisconsin Press, vol. 9(1), pages 129-142.
    12. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
    13. Thomas C. Buchmueller & Agnès Couffinhal, 2004. "Private Health Insurance in France," OECD Health Working Papers 12, OECD Publishing.
    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. Brigitte Dormont & Mathilde Péron, 2016. "Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1073-1089, September.
    2. Benjamin Montmartin & Mathieu Escot, 2017. "Local Competition and Physicians’ Pricing Decisions: New Evidence from France," GREDEG Working Papers 2017-31, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), Université Côte d'Azur, France.
    3. Dormont, B. & Péron, M., 2015. "Does health insurance encourage the rise in medical prices?," Health, Econometrics and Data Group (HEDG) Working Papers 15/16, HEDG, c/o Department of Economics, University of York.
    4. Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2023. "A model for dual health care market with congestion differentiation," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 32(2), pages 400-423, April.
    5. repec:dau:papers:123456789/15235 is not listed on IDEAS

    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. Perronnin, Marc, 2013. "Effet de l'assurance complémentaire santé sur les consommations médicales, entre risque moral et amélioration de l'accès aux soins," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13659 edited by Wittwer, Jérôme.
    2. 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.
    3. Astrid Kiil & Jacob Nielsen Arendt, 2017. "The effect of complementary private health insurance on the use of health care services," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 1-27, March.
    4. Carine Franc & Marc Perronnin & Aurelie Pierre, 2014. "Supplemental Health Insurance and Healthcare Consumption: A Dynamic Approach to Moral Hazard," Working Papers DT58, IRDES institut for research and information in health economics, revised Jan 2014.
    5. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    6. repec:spo:wpmain:info:hdl:2441/3018m4nhj18vvr47bolsnnqeqs is not listed on IDEAS
    7. repec:hal:spmain:info:hdl:2441/3018m4nhj18vvr47bolsnnqeqs is not listed on IDEAS
    8. Astrid Kiil, 2012. "Does employment-based private health insurance increase the use of covered health care services? A matching estimator approach," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 1-38, March.
    9. 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.
    10. Léa Toulemon, 2016. "Job quality, health insurance and the price of medical products : essays in applied economics [Qualité de l'emploi, assurance santé et prix des médicaments à l'hôpital : essais en économie appliqué," SciencePo Working papers Main tel-03455279, HAL.
    11. Léa Toulemon, 2016. "Job quality, Health Insurance and the Price of Medical Products: Essays in Applied Economics," Sciences Po publications info:hdl:2441/3018m4nhj18, Sciences Po.
    12. Lucien Gardiol & Pierre-Yves Geoffard & Chantal Grandchamp, 2005. "Separating selection and incentive effects in health insurance," PSE Working Papers halshs-00590713, HAL.
    13. Pierre, Aurélie & Jusot, Florence, 2017. "The likely effects of employer-mandated complementary health insurance on health coverage in France," Health Policy, Elsevier, vol. 121(3), pages 321-328.
    14. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    15. Dardanoni, Valentino & Li Donni, Paolo, 2012. "Incentive and selection effects of Medigap insurance on inpatient care," Journal of Health Economics, Elsevier, vol. 31(3), pages 457-470.
    16. 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.
    17. Alma Cohen & Peter Siegelman, 2010. "Testing for Adverse Selection in Insurance Markets," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 39-84, March.
    18. Christel E. van Dijk & Bernard van den Berg & Robert A. Verheij & Peter Spreeuwenberg & Peter P. Groenewegen & Dinny H. de Bakker, 2013. "Moral Hazard And Supplier‐Induced Demand: Empirical Evidence In General Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 340-352, March.
    19. 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.
    20. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.
    21. Carine Franc & Marc Perronnin & Aurélie Pierre, 2010. "Subscribing to Supplemental Health Insurance in France: A Dynamic Analysis of Adverse Selection," Working Papers DT35, IRDES institut for research and information in health economics, revised Dec 2010.
    22. Chung Jen Yang & Ying Che Tsai & Joseph J. Tien, 2017. "The Impacts of Persistent Behaviour and Cost-Sharing Policy on Demand for Outpatient Visits by the Elderly: Evidence from Taiwan’s National Health Insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(1), pages 31-52, January.

    More about this item

    Keywords

    Physicians’ fees; Balance billing; Supplemental insurance; I13; I14; J33;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J33 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Compensation Packages; Payment Methods

    Statistics

    Access and download statistics

    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:kap:ijhcfe:v:15:y:2015:i:2:p:269-280. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.