IDEAS home Printed from https://ideas.repec.org/p/ube/dpvwib/dp0402.html
   My bibliography  Save this paper

W hlbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?

Author

Listed:
  • Martin Schellhorn

Abstract

This paper discusses if the choice of a higher deductible in mandatory Swiss health insurance leads to a reduction of health care utilization. A GMM estimator which takes into account the potential endogeneity of the choice of the deductible is used to analyze the number of physician visits. The data from the Swiss Health Survey 2002 allow for a correct modeling of the sequence of choice of the deductible and ensuing health care utilization. Individuals were interviewed at the time of choice of the deductible and six months later. The results indicate that the observed lower number of physician visits among individuals who opted for a high deductible is caused by self-selection of healthier individuals and of individuals with less preference for health care into contracts with high deductibles. An incentive induced behavioral change towards a more parsimonious utilization of health care services cannot be found

Suggested Citation

  • Martin Schellhorn, 2004. "W hlbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?," Diskussionsschriften dp0402, Universitaet Bern, Departement Volkswirtschaft.
    • Handle: RePEc:ube:dpvwib:dp0402
    as

    Download full text from publisher

    File URL: https://repec.vwiit.ch/dp/dp0402.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. Peter Zweifel, 1986. "Die Kosten-Versicherungs-Spirale im schweizerischen Gesundheitswesen," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 122(III), pages 555-583, September.
    3. 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.
    4. John Mullahy, 1997. "Instrumental-Variable Estimation Of Count Data Models: Applications To Models Of Cigarette Smoking Behavior," The Review of Economics and Statistics, MIT Press, vol. 79(4), pages 586-593, November.
    5. Andreas Werblow, 2002. "Alles nur Selektion?: Der Einfluss von Selbstbehalten in der Gesetzlichen Krankenversicherung," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 427-436.
    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. Michael Gerfin & Martin Schellhorn, 2006. "Nonparametric bounds on the effect of deductibles in health care insurance on doctor visits – Swiss evidence," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 1011-1020, September.
    2. World Bank, 2009. "Europe and Central Asia - Health insurance and competition," World Bank Publications - Reports 3064, The World Bank Group.

    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. Martin Schellhorn, 2002. "Auswirkungen wählbarer Selbstbehalte in der Krankenversicherung: Lehren aus der Schweiz?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 411-426.
    2. Andrés Romeu & Marcos Vera-Hernández, 2005. "Counts with an endogenous binary regressor: A series expansion approach," Econometrics Journal, Royal Economic Society, vol. 8(1), pages 1-22, March.
    3. 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.
    4. Budi Hidayat & Subhash Pokhrel, 2009. "The Selection of an Appropriate Count Data Model for Modelling Health Insurance and Health Care Demand: Case of Indonesia," IJERPH, MDPI, vol. 7(1), pages 1-19, December.
    5. repec:ebl:ecbull:v:3:y:2008:i:42:p:1-13 is not listed on IDEAS
    6. Reichmann, Gerhard & Sommersguter-Reichmann, Margit, 2004. "Co-payments in the Austrian social health insurance system: Analysing patient behaviour and patients' views on the effects of co-payments," Health Policy, Elsevier, vol. 67(1), pages 75-91, January.
    7. Partha Deb & Chenghui Li & Pravin K. Trivedi & David M. Zimmer, 2006. "The effect of managed care on use of health care services: results from two contemporaneous household surveys," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 743-760, July.
    8. J. M. C. Santos Silva & Silvana Tenreyro, 2022. "The Log of Gravity at 15," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 21(3), pages 423-437, September.
    9. Lori J. Curtis & William J. MacMinn, 2008. "Health Care Utilization in Canada: Twenty-five Years of Evidence," Canadian Public Policy, University of Toronto Press, vol. 34(1), pages 65-88, March.
    10. Luz, Gregório & Barboza, Matheus H.C. & Portugal, Licinio & Giannotti, Mariana & van Wee, Bert, 2022. "Does better accessibility help to reduce social exclusion? Evidence from the city of São Paulo, Brazil," Transportation Research Part A: Policy and Practice, Elsevier, vol. 166(C), pages 186-217.
    11. Luz, Gregorio & Barboza, Matheus Henrique Cunha & da Silva Portugal, Licinio & Giannotti, Mariana & van Wee, Bert, 2022. "Does better accessibility help to reduce social exclusion? Evidence from the City of São Paulo, Brazil," SocArXiv 2p896, Center for Open Science.
    12. Karl-Michael Ortmann, 2011. "Optimal deductibles for outpatient services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(1), pages 39-47, February.
    13. Liebert, Helge & Mäder, Beatrice, 2016. "The impact of regional health care coverage on infant mortality and disease incidence," Economics Working Paper Series 1620, University of St. Gallen, School of Economics and Political Science.
    14. Stefan Boes, 2007. "Count Data Models with Unobserved Heterogeneity: An Empirical Likelihood Approach," SOI - Working Papers 0704, Socioeconomic Institute - University of Zurich.
    15. Liebert, Helge & Mäder, Beatrice, 2022. "Physicians and the Production of Health: Returns to Health Care during the Mortality Transition," IZA Discussion Papers 15220, Institute of Labor Economics (IZA).
    16. Drevs Florian & Nguyen Tristan, 2012. "Adverse Selektion light – Der Einfluss des Flat-Rate-Bias auf das Tarifwahlverhalten bei Krankenversicherungen / Adverse Selection Light – How can flat-rate bias influence insurance demand," ORDO. Jahrbuch für die Ordnung von Wirtschaft und Gesellschaft, De Gruyter, vol. 63(1), pages 365-382, January.
    17. David Mushinski & Stephan Weiler & Benjamin Widner, 2014. "The impact of retail establishments in hinterlands on the export role of retail establishments in rural places," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 52(2), pages 469-487, March.
    18. Shuang Chen, 2022. "The Positive Effect of Women’s Education on Fertility in Low-Fertility China," European Journal of Population, Springer;European Association for Population Studies, vol. 38(1), pages 125-161, March.
    19. Hongxiu Li, 2017. "Innovation as Adaptation to Natural Disasters," Working Papers 1709, University of Waterloo, Department of Economics, revised Nov 2017.
    20. Jeffrey L. Furman & Megan MacGarvie, 2007. "Academic Science and the Birth of Industrial Research Laboratories in the U.S. Pharmaceutical Industry," NBER Chapters, in: Academic Science and Entrepreneurship: Dual Engines of Growth, National Bureau of Economic Research, Inc.
    21. Mohammad Arzaghi & J. Vernon Henderson, 2008. "Networking off Madison Avenue," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 75(4), pages 1011-1038.

    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:ube:dpvwib:dp0402. 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: Franz Koelliker (email available below). General contact details of provider: https://edirc.repec.org/data/vwibech.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.