IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v122y2018i5p485-492.html
   My bibliography  Save this article

Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors

Author

Listed:
  • Tynkkynen, Liina-Kaisa
  • Alexandersen, Nina
  • Kaarbøe, Oddvar
  • Anell, Anders
  • Lehto, Juhani
  • Vrangbӕk, Karsten

Abstract

The Nordic countries are healthcare systems with tax-based financing and ambitions for universal access to comprehensive services. This implies that distribution of healthcare resources should be based on individual needs, not on the ability to pay. Despite this ideological orientation, significant expansion in voluntary private health insurance (VPHI) contracts has occurred in recent decades. The development and role of VPHIs are different across the Nordic countries. Complementary VPHI plays a significant role in Denmark and in Finland. Supplementary VPHI is prominent in Norway and Sweden. The aim of this paper is to explore drivers behind the developments of the VPHI markets in the Nordic countries. We analyze the developments in terms of the following aspects: the performance of the statutory system (real or perceived), lack of coverage in certain areas of healthcare, governmental interventions or inability to reform the system, policy trends and the general socio-cultural environment, and policy responses to voting behavior or lobbying by certain interest groups. It seems that the early developments in VPHI markets have been an answer to the gaps in the national health systems created by institutional contexts, political decisions, and cultural interpretations on the functioning of the system. However, once the market is created it introduces new dynamics that have less to do with gaps and inflexibilities and more with cultural factors.

Suggested Citation

  • Tynkkynen, Liina-Kaisa & Alexandersen, Nina & Kaarbøe, Oddvar & Anell, Anders & Lehto, Juhani & Vrangbӕk, Karsten, 2018. "Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors," Health Policy, Elsevier, vol. 122(5), pages 485-492.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:5:p:485-492
    DOI: 10.1016/j.healthpol.2018.03.008
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851018300605
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2018.03.008?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Tynkkynen, Liina-Kaisa & Chydenius, Miisa & Saloranta, Anna & Keskimäki, Ilmo, 2016. "Expanding choice of primary care in Finland: much debate but little change so far," Health Policy, Elsevier, vol. 120(3), pages 227-234.
    2. Søgaard, Rikke & Pedersen, Morten Saaby & Bech, Mickael, 2013. "To what extent does employer-paid health insurance reduce the use of public hospitals?," Health Policy, Elsevier, vol. 113(1), pages 61-68.
    3. Joan Costa‐Font & Mireia Jofre‐Bonet, 2008. "Is There A ‘Secession Of The Wealthy’? Private Health Insurance Uptake And National Health System Support," Bulletin of Economic Research, Wiley Blackwell, vol. 60(3), pages 265-287, July.
    4. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    5. Saltman, Richard B. & Teperi, Juha, 2016. "Health reform in Finland: current proposals and unresolved challenges," Health Economics, Policy and Law, Cambridge University Press, vol. 11(3), pages 303-319, July.
    6. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    7. Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April.
    8. Vrangbaek, Karsten & Robertson, Ruth & Winblad, Ulrika & Van de Bovenkamp, Hester & Dixon, Anna, 2012. "Choice policies in Northern European health systems," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 47-71, January.
    9. Besley, Timothy & Coate, Stephen, 1991. "Public Provision of Private Goods and the Redistribution of Income," American Economic Review, American Economic Association, vol. 81(4), pages 979-984, September.
    10. repec:adr:anecst:y:2006:i:83-84:p:10 is not listed on IDEAS
    11. Pierson, Paul, 2000. "Increasing Returns, Path Dependence, and the Study of Politics," American Political Science Review, Cambridge University Press, vol. 94(2), pages 251-267, June.
    12. 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.
    13. Karl Ove Aarbu, 2010. "Demand Patterns for Treatment Insurance in Norway," CESifo Working Paper Series 3021, CESifo.
    14. Joan Costa-Font & Valentina Zigante, 2016. "The choice agenda in European health systems: the role of middle-class demands," Public Money & Management, Taylor & Francis Journals, vol. 36(6), pages 409-416, September.
    15. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    16. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    17. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income‐related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608, July.
    18. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    19. Andrew M. Jones & Xander Koolman & Eddy Van Doorslaer, 2006. "The impact of having supplementary private health insurance on the uses of specialists," Annals of Economics and Statistics, GENES, issue 83-84, pages 251-275.
    20. Francesca Colombo & Nicole Tapay, 2004. "Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Papers 15, OECD Publishing.
    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. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    2. Lavaste, Konsta, 2023. "Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland," Health Policy, Elsevier, vol. 132(C).
    3. Kullberg, Linn & Blomqvist, Paula & Winblad, Ulrika, 2019. "Health insurance for the healthy? Voluntary health insurance in Sweden," Health Policy, Elsevier, vol. 123(8), pages 737-746.
    4. Marenzi, Anna & Rizzi, Dino & Zanette, Michele, 2021. "Incentives for voluntary health insurance in a national health system: Evidence from Italy," Health Policy, Elsevier, vol. 125(6), pages 685-692.
    5. Saunes, Ingrid Sperre & Vrangbæk, Karsten & Byrkjeflot, Haldor & Jervelund, Signe Smith & Birk, Hans Okkels & Tynkkynen, Liina-Kaisa & Keskimäki, Ilmo & Sigurgeirsdóttir, Sigurbjörg & Janlöv, Nils & R, 2022. "Nordic responses to Covid-19: Governance and policy measures in the early phases of the pandemic," Health Policy, Elsevier, vol. 126(5), pages 418-426.

    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. Marenzi, Anna & Rizzi, Dino & Zanette, Michele, 2021. "Incentives for voluntary health insurance in a national health system: Evidence from Italy," Health Policy, Elsevier, vol. 125(6), pages 685-692.
    2. Kullberg, Linn & Blomqvist, Paula & Winblad, Ulrika, 2019. "Health insurance for the healthy? Voluntary health insurance in Sweden," Health Policy, Elsevier, vol. 123(8), pages 737-746.
    3. Daniele Fabbri & Chiara Monfardini, 2016. "Opt Out or Top Up? Voluntary Health Care Insurance and the Public vs. Private Substitution," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 78(1), pages 75-93, February.
    4. Joan Costa-Font & Ada Ferrer-i-Carbonell, 2019. "Regional Decentralisation and the Demand for Public Health Care," Studies on the Spanish Economy eee2019-41, FEDEA.
    5. Lavaste, Konsta, 2023. "Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland," Health Policy, Elsevier, vol. 132(C).
    6. 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.
    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. Fabbri, Daniele & Monfardini, Chiara, 2009. "Rationing the public provision of healthcare in the presence of private supplements: Evidence from the Italian NHS," Journal of Health Economics, Elsevier, vol. 28(2), pages 290-304, March.
    9. Panos Pashardes & Nicoletta Pashourtidou, 2011. "Consumer welfare from publicly supplemented private goods: age and income effects on demand for health care," Empirical Economics, Springer, vol. 41(3), pages 865-885, December.
    10. Colm Harmon & Claire Finn, 2006. "A dynamic model of demand for private health insurance in Ireland," Open Access publications 10197/666, School of Economics, University College Dublin.
    11. Atella, Vincenzo & Deb, Partha, 2008. "Are primary care physicians, public and private sector specialists substitutes or complements? Evidence from a simultaneous equations model for count data," Journal of Health Economics, Elsevier, vol. 27(3), pages 770-785, May.
    12. 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.
    13. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    14. Dardanoni, Valentino & Li Donni, Paolo, 2012. "Incentive and selection effects of Medigap insurance on inpatient care," Journal of Health Economics, Elsevier, vol. 31(3), pages 457-470.
    15. Costa-Font, Joan & Ferrer-i-Carbonell, Ada, 2022. "Does devolution influence the choice and quality of public (vs private) health care?," Journal of Economic Behavior & Organization, Elsevier, vol. 202(C), pages 632-653.
    16. Elaine Kelly & George Stoye, 2015. "New joints: private providers and rising demand in the English National Health Service," IFS Working Papers W15/22, Institute for Fiscal Studies.
    17. 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.
    18. Jeremiah Hurley & Rhema Vaithianathana & Thomas F. Crossley & Deborah Cobb-Clark, 2001. "Parallel Private Health Insurance in Australia: A Cautionary Tale and Lessons for Canada," Centre for Health Economics and Policy Analysis Working Paper Series 2001-12, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    19. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    20. Ha Trong Nguyen & Huong Thu Le & Luke Connelly & Francis Mitrou, 2023. "Accuracy of self‐reported private health insurance coverage," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2709-2729, December.

    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:eee:hepoli:v:122:y:2018:i:5:p:485-492. 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: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    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.