IDEAS home Printed from https://ideas.repec.org/a/taf/recsxx/v5y2002i1p157-184.html
   My bibliography  Save this article

Choosing Health Insurance in a Dual Health Care System: The Chilean Case

Author

Listed:
  • Ricardo Sanhueza
  • Jaime Ruiz-Tagle

Abstract

In Chile there is a public insurance system where people contribute a fixed percentage of their income, and also a private system where people pay a premium based on their personal characteristics. Using a large survey for 1996, we study the determinants of the decision to buy a private health plan. We find that the probability of buying a private health plan is positively correlated with income and living in areas with private health services providers. This probability decreases as families become older, and with a larger proportion of fertile age females. We also find that people who are more likely to demand health services prefer to buy a private health plan, and that people enrolled in a private health plan increase their use of health services. The segmentation observed in the health sector relates with the way private insurers and the public insurance system set their premiums.

Suggested Citation

  • Ricardo Sanhueza & Jaime Ruiz-Tagle, 2002. "Choosing Health Insurance in a Dual Health Care System: The Chilean Case," Journal of Applied Economics, Taylor & Francis Journals, vol. 5(1), pages 157-184, May.
    • Handle: RePEc:taf:recsxx:v:5:y:2002:i:1:p:157-184
    DOI: 10.1080/15140326.2002.12040574
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1080/15140326.2002.12040574
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1080/15140326.2002.12040574?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. Propper, Carol, 1993. "Constrained choice sets in the U.K. demand for private medical insurance," Journal of Public Economics, Elsevier, vol. 51(3), pages 287-307, July.
    2. Edward C. Norton & Richard C. Lindrooth & Susan T. Ennett, 1998. "Controlling for the endogeneity of peer substance use on adolescent alcohol and tobacco use," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 439-453, August.
    3. Heckman, James J, 1978. "Dummy Endogenous Variables in a Simultaneous Equation System," Econometrica, Econometric Society, vol. 46(4), pages 931-959, July.
    4. Roger Feldman & Michael Finch & Bryan Dowd & Steven Cassou, 1989. "The Demand for Employment-Based Health Insurance Plans," Journal of Human Resources, University of Wisconsin Press, vol. 24(1), pages 115-142.
    5. Ellis, Randall P, 1989. "Employee Choice of Health Insurance," The Review of Economics and Statistics, MIT Press, vol. 71(2), pages 215-223, May.
    6. David M. Cutler & Richard J. Zeckhauser, 1998. "Adverse Selection in Health Insurance," NBER Chapters, in: Frontiers in Health Policy Research, Volume 1, pages 1-32, National Bureau of Economic Research, Inc.
    7. Short, Pamela Farley & Taylor, Amy K., 1989. "Premiums, benefits, and employee choice of health insurance options," Journal of Health Economics, Elsevier, vol. 8(3), pages 293-311, December.
    8. Marquis, M. Susan, 1992. "Adverse selection with a multiple choice among health insurance plans: A simulation analysis," Journal of Health Economics, Elsevier, vol. 11(2), pages 129-151, August.
    9. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
    10. Carol Propper, 1987. "An econometric estimation of the demand for private health insurance," Working Papers 024chedp, Centre for Health Economics, University of York.
    11. Selden, Thomas M., 1993. "Should the government provide catastrophic insurance?," Journal of Public Economics, Elsevier, vol. 51(2), pages 241-247, June.
    12. Hsiao, William C., 1995. "Abnormal economics in the health sector," Health Policy, Elsevier, vol. 32(1-3), pages 125-139.
    13. Besley, Timothy, 1989. "Publicly provided disaster insurance for health and the control of moral hazard," Journal of Public Economics, Elsevier, vol. 39(2), pages 141-156, July.
    14. Claudio Sapelli & Arístides Torche, 1998. "El Seguro Previsional de Salud: Determinantes de la Elección entre Seguro Público y Privado, 1990-1994," Latin American Journal of Economics-formerly Cuadernos de Economía, Instituto de Economía. Pontificia Universidad Católica de Chile., vol. 35(106), pages 383-406.
    15. Nelson, Forrest & Olson, Lawrence, 1978. "Specification and Estimation of a Simultaneous-Equation Model with Limited Dependent Variables," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 19(3), pages 695-709, October.
    16. Kenneth Bollen & David Guilkey & Thomas Mroz, 1995. "Binary outcomes and endogenous explanatory variables: Tests and solutions with an application to the demand for contraceptive use in tunisia," Demography, Springer;Population Association of America (PAA), vol. 32(1), pages 111-131, February.
    17. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    18. Amemiya, Takeshi, 1979. "The Estimation of a Simultaneous-Equation Tobit Model," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 20(1), pages 169-181, February.
    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. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    2. Pardo, Cristian, 2019. "Health care reform, adverse selection and health insurance choice," Journal of Health Economics, Elsevier, vol. 67(C).
    3. Villena, Marcelo & Bitrán, Eduardo & Duarte, Fabián & Fernandes, Dalila, 2017. "Impact of the Guaranteed Health Plan with a single community premium on the demand for private health insurance in Chile," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), December.
    4. Rotarou, Elena S. & Sakellariou, Dikaios, 2017. "Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile," Health Policy, Elsevier, vol. 121(5), pages 495-503.
    5. Bronfman, Javier, 2011. "Health Insurance Choice, Moral Hazard and Adverse Selection: A Study of the Chilean Case Using Panel Data," MPRA Paper 63266, University Library of Munich, Germany.
    6. Hubert Amu & Kwamena Sekyi Dickson & Akwasi Kumi-Kyereme & Eugene Kofuor Maafo Darteh, 2018. "Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-14, August.
    7. Duarte, Fabian, 2012. "Price elasticity of expenditure across health care services," Journal of Health Economics, Elsevier, vol. 31(6), pages 824-841.
    8. Bronfman, Javier, 2014. "Universal health insurance under a dual system, evidence of adverse selection against the public sector: the case of Chile," MPRA Paper 63262, University Library of Munich, Germany.
    9. Cristian Pardo & Whitney Schott, 2012. "Public versus private: evidence on health insurance selection," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 39-61, March.
    10. Ricardo Henriquez Hofter, 2006. "Private health insurance and utilization of health services in Chile," Applied Economics, Taylor & Francis Journals, vol. 38(4), pages 423-439.

    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. Sapelli, Claudio & Vial, Bernardita, 2003. "Self-selection and moral hazard in Chilean health insurance," Journal of Health Economics, Elsevier, vol. 22(3), pages 459-476, May.
    2. Alan C. Monheit & Thomas M. Selden, 2000. "Cross‐subsidization in the market for employment‐related health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 9(8), pages 699-714, December.
    3. Matthew Jowett, 2004. "Theoretical insights into the development of health insurance in low-income countries," Working Papers 188chedp, Centre for Health Economics, University of York.
    4. 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.
    5. 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.
    6. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2018. "Can premium differentiation counteract adverse selection in the Dutch supplementary health insurance? A simulation study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(5), pages 757-768, June.
    7. Julia Bredtmann, 2014. "The Intra-household Division of Labor: An Empirical Analysis of Spousal Influences on Individual Time Allocation," LABOUR, CEIS, vol. 28(1), pages 1-39, March.
    8. Jean Marie Abraham & William B. Vogt & Martin Gaynor, 2002. "Household Demand for Employer-Based Health Insurance," NBER Working Papers 9144, National Bureau of Economic Research, Inc.
    9. Finkelstein, Amy, 2004. "The interaction of partial public insurance programs and residual private insurance markets: evidence from the US Medicare program," Journal of Health Economics, Elsevier, vol. 23(1), pages 1-24, January.
    10. Chesher, Andrew & Kim, Dongwoo & Rosen, Adam M., 2023. "IV methods for Tobit models," Journal of Econometrics, Elsevier, vol. 235(2), pages 1700-1724.
    11. Matzkin, Rosa L., 2012. "Identification in nonparametric limited dependent variable models with simultaneity and unobserved heterogeneity," Journal of Econometrics, Elsevier, vol. 166(1), pages 106-115.
    12. Jose Maria Labeaga & Ester Martinez-Ros, 1994. "Estimación de un modelo de ecuaciones simultáneas con variables dependientes limitadas: una aplicación con datos de la industria española," Investigaciones Economicas, Fundación SEPI, vol. 18(3), pages 465-489, September.
    13. 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.
    14. Partha Deb & Virginia Wilcox‐Gök & Ann Holmes & Jeffrey Rubin, 1996. "Choice of health insurance by families of the mentally ill," Health Economics, John Wiley & Sons, Ltd., vol. 5(1), pages 61-76, January.
    15. Bachmann, Ronald & Beimann, Boris & Bredtmann, Julia & David, Peggy & Ehlert, Christoph & Kassenböhmer, Sonja & Schaffner, Sandra & Siemers, Lars, 2011. "Studies on flexicurity Lot 1: Study on various aspects of labour market performance using micro data from the European Union statistics on income and living conditions (EU-SILC). Contract No. VC/2010/," RWI Projektberichte, RWI - Leibniz-Institut für Wirtschaftsforschung, number 72620, March.
    16. Jacob N. Arendt, 2002. "Endogeneity and Heterogeneity in LDV Panel Data Models," 10th International Conference on Panel Data, Berlin, July 5-6, 2002 D6-1, International Conferences on Panel Data.
    17. Andreas Million & Regina T. Riphahn & Achim Wambach, 2003. "Incentive effects in the demand for health care: a bivariate panel count data estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(4), pages 387-405.
    18. Ricardo Henriquez Hofter, 2006. "Private health insurance and utilization of health services in Chile," Applied Economics, Taylor & Francis Journals, vol. 38(4), pages 423-439.
    19. Lydia Zepeda & Robin Douthitt & So‐Ye You, 2003. "Consumer Risk Perceptions Toward Agricultural Biotechnology, Self‐Protection, and Food Demand: The Case of Milk in the United States," Risk Analysis, John Wiley & Sons, vol. 23(5), pages 973-984, October.
    20. Panos Kanavos & Marin Gemmill-Toyama, 2010. "Prescription drug coverage among elderly and disabled Americans: can Medicare—Part D reduce inequities in access?," International Journal of Health Economics and Management, Springer, vol. 10(3), pages 203-218, September.

    More about this item

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    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:taf:recsxx:v:5:y:2002:i:1:p:157-184. 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: Chris Longhurst (email available below). General contact details of provider: http://www.tandfonline.com/recs .

    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.