IDEAS home Printed from https://ideas.repec.org/p/diw/diwsop/diw_sp141.html
   My bibliography  Save this paper

Do Optional Deductibles Reduce the Number of Doctor Visits?: Empirical Evidence with German Data

Author

Listed:
  • Hendrik Schmitz

Abstract

Deductibles in health insurance are often regarded as a means to contain health care costs when individuals exhibit moral hazard. However, in the absence of moral hazard, voluntarily chosen deductibles may instead lead to self-selection into different insurance contracts. We use a set of new variables in the German Socioeconomic Panel for the years 2002, 2004, and 2006 that measure individual health more accurately and include risk-attitudes towards health in order to determine the price elasticity of demand for health care. A latent class approach that takes into account the panel structure of the data reveals that the effect of deductibles on the number of doctor visits is negligible. Private add-on insurance increases the number of doctor visits. However, altogether the effects of the insurance state on the demand for doctor visits are small in magnitude.

Suggested Citation

  • Hendrik Schmitz, 2008. "Do Optional Deductibles Reduce the Number of Doctor Visits?: Empirical Evidence with German Data," SOEPpapers on Multidisciplinary Panel Data Research 141, DIW Berlin, The German Socio-Economic Panel (SOEP).
    • Handle: RePEc:diw:diwsop:diw_sp141
    as

    Download full text from publisher

    File URL: https://www.diw.de/documents/publikationen/73/diw_01.c.90074.de/diw_sp0141.pdf
    Download Restriction: no
    ---><---

    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. Million, Andreas & Rotte, Ralph & Zimmermann, Klaus F, 1996. "Economic Incentives and Hospitalization in Germany," CEPR Discussion Papers 1516, C.E.P.R. Discussion Papers.
    3. repec:diw:diwwpp:dp689 is not listed on IDEAS
    4. Clark, Andrew E. & Etile, Fabrice, 2006. "Don't give up on me baby: Spousal correlation in smoking behaviour," Journal of Health Economics, Elsevier, vol. 25(5), pages 958-978, September.
    5. Thomas Dohmen & Armin Falk & David Huffman & Uwe Sunde & Jürgen Schupp & Gert G. Wagner, 2005. "Individual Risk Attitudes: New Evidence from a Large, Representative, Experimentally-Validated Survey," Discussion Papers of DIW Berlin 511, DIW Berlin, German Institute for Economic Research.
    6. Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July.
    7. Markus M. Grabka, 2006. "Prämien in der PKV: deutlich stärkerer Anstieg als in der gesetzlichen Krankenversicherung," DIW Wochenbericht, DIW Berlin, German Institute for Economic Research, vol. 73(46), pages 653-659.
    8. Geil, Peter, et al, 1997. "Economic Incentives and Hospitalization in Germany," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 295-311, May-June.
    9. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
    10. Windmeijer, F A G & Silva, J M C Santos, 1997. "Endogeneity in Count Data Models: An Application to Demand for Health Care," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 281-294, May-June.
    11. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    12. Hendrik Jürges, 2007. "Health Insurance Status and Physician-Induced Demand for Medical Services in Germany: New Evidence from Combined District and Individual Level Data," Discussion Papers of DIW Berlin 689, DIW Berlin, German Institute for Economic Research.
    13. Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892, September.
    14. Buchner, Florian & Wasem, Jurgen, 2003. "Needs for further improvement: risk adjustment in the German health insurance system," Health Policy, Elsevier, vol. 65(1), pages 21-35, July.
    15. Laura Greene Knapp & Terry Seaks, 1998. "A Hausman test for a dummy variable in probit," Applied Economics Letters, Taylor & Francis Journals, vol. 5(5), pages 321-323.
    16. Bauer, Thomas & Augurzky, Boris & Schaffner, Sandra, 2006. "Copayments in the German Health System - Does it Work?," CEPR Discussion Papers 5869, C.E.P.R. Discussion Papers.
    17. Gert G. Wagner & Joachim R. Frick & Jürgen Schupp, 2007. "The German Socio-Economic Panel Study (SOEP) – Scope, Evolution and Enhancements," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 127(1), pages 139-169.
    18. 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.
    19. Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July.
    20. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    21. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    22. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    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. Hendrik Schmitz, 2012. "More health care utilization with more insurance coverage? Evidence from a latent class model with German data," Applied Economics, Taylor & Francis Journals, vol. 44(34), pages 4455-4468, December.
    2. Schmitz, Hendrik, 2008. "Do Optional Deductibles Reduce the Number of Doctor Visits? – Empirical Evidence with German Data," Ruhr Economic Papers 76, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    3. repec:zbw:rwirep:0076 is not listed on IDEAS
    4. Hendrik Schmitz, 2008. "Do Optional Deductibles Reduce the Number of Doctor Visits? – Empirical Evidence with German Data," Ruhr Economic Papers 0076, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    5. Bago d'Uva, Teresa & Jones, Andrew M., 2009. "Health care utilisation in Europe: New evidence from the ECHP," Journal of Health Economics, Elsevier, vol. 28(2), pages 265-279, March.
    6. Sisira Sarma & Wayne Simpson, 2006. "A microeconometric analysis of Canadian health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 219-239, March.
    7. Hullegie, P.G.J., 2012. "Essays on health and labor economics," Other publications TiSEM dcc68fc9-7af1-4ba9-8f90-6, Tilburg University, School of Economics and Management.
    8. Teresa Bago d'Uva, 2006. "Latent class models for utilisation of health care," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 329-343, April.
    9. McLeod, Logan, 2011. "A nonparametric vs. latent class model of general practitioner utilization: Evidence from Canada," Journal of Health Economics, Elsevier, vol. 30(6), pages 1261-1279.
    10. Partha Deb & Pravin K. Trivedi, 2012. "Empirical Models of Health Care Use," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 14, Edward Elgar Publishing.
    11. Monika Sander, 2008. "Is There Migration-Related Inequity in Access to or in the Utilisation of Health Care in Germany?," SOEPpapers on Multidisciplinary Panel Data Research 147, DIW Berlin, The German Socio-Economic Panel (SOEP).
    12. Aysit Tansel & Halil Ibrahim Keskin, 2017. "Education Effects on Days Hospitalized and Days out of Work by Gender: Evidence from Turkey," Koç University-TUSIAD Economic Research Forum Working Papers 1721, Koc University-TUSIAD Economic Research Forum.
    13. 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.
    14. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.
    15. Winkelmann, Rainer, 2006. "Reforming health care: Evidence from quantile regressions for counts," Journal of Health Economics, Elsevier, vol. 25(1), pages 131-145, January.
    16. René Petilliot, 2017. "The Effect of Private Health Insurance on Self-assessed Health Status and Health Satisfaction in Germany," SOEPpapers on Multidisciplinary Panel Data Research 917, DIW Berlin, The German Socio-Economic Panel (SOEP).
    17. 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.
    18. Udo Schneider & Volker Ulrich, 2008. "The physician-patient relationship revisited: the patient’s view," International Journal of Health Economics and Management, Springer, vol. 8(4), pages 279-300, December.
    19. José-Ignacio Antón & Rafael Muñoz de Bustillo, 2010. "Health care utilisation and immigration in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 487-498, October.
    20. Daniele Fabbri & Chiara Monfardini, 2003. "Public vs. Private Health Care Services Demand in Italy," Giornale degli Economisti, GDE (Giornale degli Economisti e Annali di Economia), Bocconi University, vol. 62(1), pages 93-123, April.
    21. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724, July.

    More about this item

    Keywords

    Health insurance; deductibles; add-on insurance; count data; latent class panel model;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies

    NEP fields

    This paper has been announced in the following NEP Reports:

    Lists

    This item is featured on the following reading lists, Wikipedia, or ReplicationWiki pages:
    1. SOEP based publications

    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:diw:diwsop:diw_sp141. 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: Bibliothek (email available below). General contact details of provider: https://edirc.repec.org/data/sodiwde.html .

    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.