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

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  • 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.

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  • 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
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    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. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Pardo, Cristian, 2019. "Health care reform, adverse selection and health insurance choice," Journal of Health Economics, Elsevier, vol. 67(C).
    7. 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.
    8. Duarte, Fabian, 2012. "Price elasticity of expenditure across health care services," Journal of Health Economics, Elsevier, vol. 31(6), pages 824-841.
    9. 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.
    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.

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    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

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