IDEAS home Printed from https://ideas.repec.org/p/irh/wpaper/dt58.html
   My bibliography  Save this paper

Supplemental Health Insurance and Healthcare Consumption: A Dynamic Approach to Moral Hazard

Author

Listed:
  • Carine Franc

    (CERMES centre de recherche medecine, sciences, sante et societe)

  • Marc Perronnin

    (IRDES Institute for research and information in health economics)

  • Aurelie Pierre

    (IRDES Institute for research and information in health economics)

Abstract

We analyze the existence and persistence of moral hazard over time to test the assumption of pent-up demand. We consider the effects of supplemental health insurance provided by a private insurer when added to compulsory public insurance already supplemented by private insurance. Using panel data from a French mutuelle, we compute error component models with the Chamberlain specification to control for adverse selection. By separating outpatient care consumption into (1) the probability of healthcare use, (2) the number of uses conditional on use and (3) the per-unit cost of care, we provide evidence that supplemental insurance is significantly and positively associated with (1), (2) and (3). However, these effects decrease significantly over time. This pattern supports the existence of pent-up demand, the magnitude of which varies greatly and depends on the dimensions (1), (2) and (3) and the type of care (physician care, prescription drugs, dental care or optical care)..

Suggested Citation

  • Carine Franc & Marc Perronnin & Aurelie Pierre, 2014. "Supplemental Health Insurance and Healthcare Consumption: A Dynamic Approach to Moral Hazard," Working Papers DT58, IRDES institut for research and information in health economics, revised Jan 2014.
    • Handle: RePEc:irh:wpaper:dt58
    as

    Download full text from publisher

    File URL: https://www.irdes.fr/english/working-papers/058-supplemental-health-insurance-and-healthcare-consumption-a-dynamic-approach-to-moral-hazard.pdf
    File Function: First version, 2014
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. Bolhaar, Jonneke & Lindeboom, Maarten & van der Klaauw, Bas, 2012. "A dynamic analysis of the demand for health insurance and health care," European Economic Review, Elsevier, vol. 56(4), pages 669-690.
    3. Chamberlain, Gary, 1984. "Panel data," Handbook of Econometrics, in: Z. Griliches† & M. D. Intriligator (ed.), Handbook of Econometrics, edition 1, volume 2, chapter 22, pages 1247-1318, Elsevier.
    4. de Meza, David, 1983. "Health insurance and the demand for medical care," Journal of Health Economics, Elsevier, vol. 2(1), pages 47-54, March.
    5. 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.
    6. Wooldridge, Jeffrey M., 1995. "Selection corrections for panel data models under conditional mean independence assumptions," Journal of Econometrics, Elsevier, vol. 68(1), pages 115-132, July.
    7. Blomqvist, Ake, 2001. "Does the economics of moral hazard need to be revisited? A comment on the paper by John Nyman," Journal of Health Economics, Elsevier, vol. 20(2), pages 283-288, March.
    8. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    9. Long, Stephen H. & Marquis, M. Susan & Rodgers, Jack, 1998. "Do people shift their use of health services over time to take advantage of insurance?," Journal of Health Economics, Elsevier, vol. 17(1), pages 105-115, January.
    10. Ettner, Susan L., 1997. "Adverse selection and the purchase of Medigap insurance by the elderly," Journal of Health Economics, Elsevier, vol. 16(5), pages 543-562, October.
    11. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    12. Thomas C. Buchmueller & Agnès Couffinhal, 2004. "Private Health Insurance in France," OECD Health Working Papers 12, OECD Publishing.
    13. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
    14. Laurent Caussat & Michel Glaude, 1993. "Dépenses médicales et couverture sociale," Économie et Statistique, Programme National Persée, vol. 265(1), pages 31-43.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kevin Devereux & Mona Balesh Abadi & Farah Omran, 2019. "Correcting for Transitory Effects in RCTs: Application to the RAND Health Insurance Experiment," Working Papers 201910, School of Economics, University College Dublin.
    2. Iwona Laskowska, 2015. "Private health insurance and the problem of moral hazard (Prywatne ubezpieczenia zdrowotne a problem pokusy naduzycia)," Problemy Zarzadzania, University of Warsaw, Faculty of Management, vol. 13(53), pages 58-68.
    3. Pierre, Aurélie & Jusot, Florence, 2017. "The likely effects of employer-mandated complementary health insurance on health coverage in France," Health Policy, Elsevier, vol. 121(3), pages 321-328.
    4. Raphaël Cottin, 2018. "Free health care for the poor: a good way to achieve universal health coverage? Evidence from Morocco," Working Papers DT/2018/16, DIAL (Développement, Institutions et Mondialisation).

    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. Carine Franc & Marc Perronnin & Aurélie Pierre, 2016. "Supplemental Health Insurance and Healthcare Consumption—A Dynamic Approach to Moral Hazard," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1582-1598, December.
    3. 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.
    4. Izabela Jelovac, 2015. "Physicians’ balance billing, supplemental insurance and access to health care," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 269-280, June.
    5. Carine Franc & Marc Perronnin & Aurélie Pierre, 2010. "Subscribing to Supplemental Health Insurance in France: A Dynamic Analysis of Adverse Selection," Working Papers DT35, IRDES institut for research and information in health economics, revised Dec 2010.
    6. Ko, Hansoo, 2020. "Moral hazard effects of supplemental private health insurance in Korea," Social Science & Medicine, Elsevier, vol. 265(C).
    7. 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.
    8. Nikos Nomikos & Panagiota Naoum & Vasiliki Naoum & Kostas Athanasakis & John Kyriopoulos & Elpida Pavi, 2022. "Individuals' personal characteristics associated with private health insurance policy possession in Greece," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 361-371, January.
    9. Sofia Vaz & Pedro Ramos, 2016. "Where did civil servants go? the effect of an increase in public co-payments on double insured patients," Health Economics Review, Springer, vol. 6(1), pages 1-8, December.
    10. Pierre, Aurélie & Jusot, Florence, 2017. "The likely effects of employer-mandated complementary health insurance on health coverage in France," Health Policy, Elsevier, vol. 121(3), pages 321-328.
    11. repec:spo:wpmain:info:hdl:2441/3018m4nhj18vvr47bolsnnqeqs is not listed on IDEAS
    12. repec:hal:spmain:info:hdl:2441/3018m4nhj18vvr47bolsnnqeqs is not listed on IDEAS
    13. Christine Sevilla-Dedieu & Nathalie Billaudeau & Alain Paraponaris, 2020. "Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment," Health Economics Review, Springer, vol. 10(1), pages 1-10, December.
    14. 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.
    15. Randall Ellis & Elizabeth Savage, 2008. "Run for cover now or later? The impact of premiums, threats and deadlines on private health insurance in Australia," International Journal of Health Economics and Management, Springer, vol. 8(4), pages 257-277, December.
    16. Alma Cohen & Peter Siegelman, 2010. "Testing for Adverse Selection in Insurance Markets," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 39-84, March.
    17. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    18. Renate Lange & Jörg Schiller & Petra Steinorth, 2017. "Demand and Selection Effects in Supplemental Health Insurance in Germany," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(1), pages 5-30, January.
    19. Nyman, John A. & Koc, Cagatay & Dowd, Bryan E. & McCreedy, Ellen & Trenz, Helen Markelova, 2018. "Decomposition of moral hazard," Journal of Health Economics, Elsevier, vol. 57(C), pages 168-178.
    20. 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.
    21. Léa Toulemon, 2016. "Job quality, health insurance and the price of medical products : essays in applied economics [Qualité de l'emploi, assurance santé et prix des médicaments à l'hôpital : essais en économie appliqué," SciencePo Working papers Main tel-03455279, HAL.
    22. Kiil, Astrid, 2012. "Private health insurance and the use of health care services - a review of the theoretical literature with application to voluntary private health insurance in universal health care systems," DaCHE discussion papers 2012:1, University of Southern Denmark, Dache - Danish Centre for Health Economics.

    More about this item

    Keywords

    Supplemental health insurance; moral hazard; health care expenditures; longitudinal analysis;
    All these keywords.

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:irh:wpaper:dt58. 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: Jacques Harrouin (email available below). General contact details of provider: https://edirc.repec.org/data/credefr.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.