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

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  • 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
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    References listed on IDEAS

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    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.
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    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.

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