IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v17y2008i2p203-219.html
   My bibliography  Save this article

Does free complementary health insurance help the poor to access health care? Evidence from France

Author

Listed:
  • Michel Grignon
  • Marc Perronnin
  • John N. Lavis

Abstract

The French government introduced a ‘free complementary health insurance plan’ in 2000, which covers most of the out‐of‐pocket payments faced by the poorest 10% of French residents. This plan was designed to help the non‐elderly poor to access health care. To assess the impact of the introduction of the plan on its beneficiaries, we use a longitudinal data set to compare, for the same individual, the evolution of his/her expenditures before‐and‐after enrolment in the plan. This before‐and‐after analysis allows us to remove most of the spuriousness due to individual heterogeneity. We also use information on past coverage in a difference‐in‐difference analysis to evaluate the impact of specific benefits associated with the plan. We attempt at controlling for changes other than enrolment through a difference‐in‐difference analysis within the eligible (rather than enrolled) population. Our main result is the plan's lack of an overall effect on utilization. This result is likely attributable to the fact that those who were enrolled automatically in the free plan (the majority of enrollees), already benefited from a relatively generous plan. The significant effect among those who enrolled voluntarily in the free plan was likely driven by those with no previous complementary coverage. Copyright © 2007 John Wiley & Sons, Ltd.

Suggested Citation

  • Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219, February.
    • Handle: RePEc:wly:hlthec:v:17:y:2008:i:2:p:203-219
    DOI: 10.1002/hec.1250
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1250
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1250?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
    ---><---

    References listed on IDEAS

    as
    1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456, July.
    2. 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.
    3. Geoffard, Pierre-Yves & Gardiol, Lucien & Grandchamp, Chantal, 2005. "Separating Selection and Incentive Effects in Health Insurance," CEPR Discussion Papers 5380, C.E.P.R. Discussion Papers.
    4. Currie, J. & Thomas, D., 1993. "Medical Care for Children: Public Insurance, Private Insurance and Radical Differences in Utilisation," Papers 93-39, RAND - Labor and Population Program.
    5. Rainer Winkelmann, 2004. "Co‐payments for prescription drugs and the demand for doctor visits – Evidence from a natural experiment," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1081-1089, November.
    6. Newhouse, Joseph P. & Phelps, Charles E. & Marquis, M. Susan, 1980. "On having your cake and eating it too : Econometric problems in estimating the demand for health services," Journal of Econometrics, Elsevier, vol. 13(3), pages 365-390, August.
    7. Janet Currie & Duncan Thomas, 1995. "Medical Care for Children: Public Insurance, Private Insurance, and Racial Differences in Utilization," Journal of Human Resources, University of Wisconsin Press, vol. 30(1), pages 135-162.
    Full references (including those not matched with items 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. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
    3. Rob J. M. Alessie & Viola Angelini & Jochen O. Mierau & Laura Viluma, 2020. "Moral hazard and selection for voluntary deductibles," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1251-1269, October.
    4. 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.
    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. 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.
    7. 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.
    8. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).
    9. Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
    10. Layte, Richard & Nolan, Anne & McGee, Hannah & O'Hanlon, Ann, 2009. "Do consultation charges deter general practitioner use among older people? A natural experiment," Social Science & Medicine, Elsevier, vol. 68(8), pages 1432-1438, April.
    11. 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.
    12. 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.
    13. 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.
    14. Pau Olivella & Marcos Vera-Hernandez, 2006. "Testing for adverse selection into private medical insurance," IFS Working Papers W06/02, Institute for Fiscal Studies.
    15. Chantal Grandchamp & Lucien Gardiol, 2008. "Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?," Working Papers 0801, University of Lausanne, Institute of Health Economics and Management (IEMS).
    16. Renate Lange & Jörg Schiller & Petra Steinorth, 2015. "Demand and Selection Effects in Supplemental Health Insurance in Germany," SOEPpapers on Multidisciplinary Panel Data Research 757, DIW Berlin, The German Socio-Economic Panel (SOEP).
    17. Carol Rapaport & Christopher A. Trenholm, 2000. "What do we really know about trends in outpatient medical expenditures for children, 1977-1987?," Staff Reports 97, Federal Reserve Bank of New York.
    18. Devlin, Rose Anne & Sarma, Sisira & Zhang, Qi, 2011. "The role of supplemental coverage in a universal health insurance system: Some Canadian evidence," Health Policy, Elsevier, vol. 100(1), pages 81-90, April.
    19. Galina Besstremyannaya, 2014. "Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators," Discussion Papers 14-014, Stanford Institute for Economic Policy Research.
    20. 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.

    More about this item

    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:wly:hlthec:v:17:y:2008:i:2:p:203-219. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.