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A Structural Microsimulation Model for Demand-Side Cost-Sharing in Healthcare

Author

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  • Minke Remmerswaal
  • Jan Boone

    (CPB Netherlands Bureau for Economic Policy Analysis)

Abstract

Demand-side cost-sharing schemes reduce moral hazard in healthcare at the expense of out-of-pocket risk and equity. With a structural microsimulation model, we show that shifting the starting point of the deductible away from zero to 400 euros for all insured individuals, leads to an average 4 percent reduction in healthcare expenditure and 47 percent lower out-of-pocket payments. We use administrative healthcare expenditure data and focus on the price elastic part of the Dutch population to analyze the differences between the cost-sharing schemes. The model is estimated with a Bayesian mixture model to capture distributions of healthcare expenditure with which we predict the effects of cost-sharing schemes that are not present in our data.

Suggested Citation

  • Minke Remmerswaal & Jan Boone, 2020. "A Structural Microsimulation Model for Demand-Side Cost-Sharing in Healthcare," CPB Discussion Paper 415, CPB Netherlands Bureau for Economic Policy Analysis.
    • Handle: RePEc:cpb:discus:415
    DOI: 10.34932/2dcx-9103
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    References listed on IDEAS

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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