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Planes Mínimos Obligatorios en Mercados de Seguros de Salud Segmentados

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El trabajo analiza el efecto de la introducción de un plan mínimo obligatorio de prestaciones (PMO) que tanto el seguro público como los seguros privados deben cubrir. El análisis se realiza considerando la existencia de un mercado de seguros de salud segmentado en el sentido que, previo a la introducción del PMO, el seguro público sólo atiende a individuos de alto riesgo y los seguros privados sólo a individuos de riesgo bajo (la segmentación se obtiene de manera endógena en el modelo). Al caracterizar el equilibrio una vez que se introduce la reforma se puede constatar cómo la situación de los individuos de alto riesgo mejora en tanto que la de los de bajo riesgo empeora. La reforma introduce indirectamente un mecanismo de subsidios implícitos que otorgan cierta “solidaridad” al sistema, aun cuando la reforma no lo promueva de manera explícita mediante mecanismos de compensación de riesgos. Se demuestra que para que este mecanismo opere y la reforma tenga algún impacto es imprescindible que se regulen tanto el precio como la calidad asociados al PMO y que el regulador tenga la capacidad de hacer cumplir que los privados efectivamente tengan el PMO disponible para todos los tipos de asegurados.

Suggested Citation

  • Edmundo Beteta & Manuel Willington, 2007. "Planes Mínimos Obligatorios en Mercados de Seguros de Salud Segmentados," ILADES-UAH Working Papers inv198, Universidad Alberto Hurtado/School of Economics and Business.
    • Handle: RePEc:ila:ilades:inv198
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    Cited by:

    1. Willington Manuel & Alegría Alexander, 2012. "Collusion in a One-Period Insurance Market with Adverse Selection," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 12(1), pages 1-32, April.

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    More about this item

    Keywords

    seguros de salud; planes mínimos obligatorios; competencia administrada;
    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

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