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The role of supplemental coverage in a universal health insurance system: Some Canadian evidence

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  • Devlin, Rose Anne
  • Sarma, Sisira
  • Zhang, Qi

Abstract

Objective To examine the effect of supplemental health insurance for prescription drug coverage on health care utilization as measured by the number of visits to physicians in a setting with incomplete public insurance coverage.Methods A latent-class modeling approach is used to capture the presence of latent heterogeneity in the utilization of physician services. The insurance variable is grouped into three different types, depending upon how it is provided - by government, employers, or private companies. The data for this study come from the Ontario component of the Canadian Community Health Survey 2005, a representative sample of the Ontario population, conducted by Statistics Canada.Results We find that physician health care utilization responds to the presence and type of insurance, and that the results vary substantially across different types of individuals based on unobservable health status characterized by two latent classes: low users (healthy) and high users (less healthy).Conclusions The fact that not all individuals have access to supplemental insurance for prescription drug coverage calls into question the universality of public insurance that does not cover important complementary services, such as outpatient prescription drugs.

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Bibliographic Info

Article provided by Elsevier in its journal Health Policy.

Volume (Year): 100 (2011)
Issue (Month): 1 (April)
Pages: 81-90

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Handle: RePEc:eee:hepoli:v:100:y:2011:i:1:p:81-90

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Web page: http://www.elsevier.com/locate/healthpol

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Keywords: Health insurance Physician visits Latent-class model Ontario;

References

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  1. Rainer Winkelmann, 2004. "Co-payments for prescription drugs and the demand for doctor visits - Evidence from a natural experiment," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1081-1089.
  2. 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.
  3. McDonald, James Ted & Kennedy, Steven, 2004. "Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada," Social Science & Medicine, Elsevier, vol. 59(8), pages 1613-1627, October.
  4. Sara Allin & Jeremiah Hurley, 2009. "Inequity in publicly funded physician care: what is the role of private prescription drug insurance?," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1218-1232.
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  6. S Birch & J Eyles & KM Newbold, 1993. "Equitable Access to Health Care: Methodological Extensions to the Analysis of Physician Utilization in Canada," Centre for Health Economics and Policy Analysis Working Paper Series 1993-03, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  7. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
  8. 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.
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  10. Finkelstein, Amy, 2004. "The interaction of partial public insurance programs and residual private insurance markets: evidence from the US Medicare program," Journal of Health Economics, Elsevier, vol. 23(1), pages 1-24, January.
  11. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics, Canadian Economics Association, vol. 34(4), pages 921-942, November.
  12. Newbold, K. Bruce & Eyles, John & Birch, Stephen, 1995. "Equity in health care: Methodological contributions to the analysis of hospital utilization within Canada," Social Science & Medicine, Elsevier, vol. 40(9), pages 1181-1192, May.
  13. Li, Xin & Guh, Daphne & Lacaille, Diane & Esdaile, John & Anis, Aslam H., 2007. "The impact of cost sharing of prescription drug expenditures on health care utilization by the elderly: Own- and cross-price elasticities," Health Policy, Elsevier, vol. 82(3), pages 340-347, August.
  14. Ricardo Henriquez Hofter, 2006. "Private health insurance and utilization of health services in Chile," Applied Economics, Taylor & Francis Journals, vol. 38(4), pages 423-439.
  15. 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.
  16. 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.
  17. Sarma, Sisira & Basu, Kisalaya & Gupta, Anil, 2007. "The influence of prescription drug insurance on psychotropic and non-psychotropic drug utilization in Canada," Social Science & Medicine, Elsevier, vol. 65(12), pages 2553-2565, December.
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Cited by:
  1. Allin, Sara & Law, Michael R. & Laporte, Audrey, 2013. "How does complementary private prescription drug insurance coverage affect seniors’ use of publicly funded medications?," Health Policy, Elsevier, vol. 110(2), pages 147-155.

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