Biased selection within the social health insurance market in Colombia
AbstractReducing the impact of insurance market failures with regulations such as community-rated premiums, standardized benefit packages and open enrolment, yield limited impact because they create room for selection bias. The Colombian social health insurance system started a market approach in 1993 on the expectation to improve performance of preexisting monopolistic insurance funds by exposing them to competition by new entrants. It is hypothesized that market failures would lead to biased selection favoring new entrants. Two household surveys are analyzed using Self-reported health status and the presence of chronic conditions as indicators of prospective risk of enrolees. Biased selection is found to take place, leading to adverse selection among incumbents, and favorable selection among new entrants. This pattern is observed in 1997 and worsens in 2003. Although the two incumbents analyzed are public organizations, and their size dropped substantially between these two years, fiscal implications in terms of government bailouts are analyzed. ******************************************************************************************************************* Las regulaciones como primaje comunitario, paquetes estandarizados y afiliacion abierta, orientados a reducir los impactos de las fallas en los mercados de seguros, tienen un efecto limitado puesto que abren espacio a la selecciÃ³n sesgada. A partir de 1993, el sistema de seguridad social en salud en Colombia fue reformado hacia un enfoque de mercado con la expectativa de mejorar el desempeÃ±o de los monopolios preexistentes exponiÃ©ndolos a la competencia de nuevos entrantes. La hipÃ³tesis que se maneja en el trabajo es que las fallas de mercado pueden llevar a selecciÃ³n sesgada favoreciendo a los nuevos entrantes. Se analizaron dos encuestas de hogares utilizando el estado de salud auto reportado y la presencia de enfermedad crÃ³nica como indicadores prospectivos de riesgo de los afiliados. Se encuentra que hay se
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Bibliographic InfoArticle provided by Elsevier in its journal Health Policy.
Volume (Year): 79 (2006)
Issue (Month): 2-3 (December)
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Web page: http://www.elsevier.com/locate/healthpol
Other versions of this item:
- Ramón Abel Castaño & Andrés Zambrano, 2005. "Biased selection within the social health insurance market in Colombia," BORRADORES DE INVESTIGACIÃN 002063, UNIVERSIDAD DEL ROSARIO.
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Amir Shmueli, 2001. "The effect of health on acute care supplemental insurance ownership: an empirical analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 341-350.
- Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July.
- Ronald Eduardo Gómez Suárez, 2007. "Cream-Skimming And Risk Adjustment in Colombian Health Insurance System:: The Public Insurer Case," ARCHIVOS DE ECONOMÃA 004295, DEPARTAMENTO NACIONAL DE PLANEACIÓN.
- Alejandro Arrieta & Ariadna García Prado & Giota Panopoulou, 2012. "Enrolling the Self-Employed in Mandatory Health Insurance in Colombia: are we missing other factors?," Documentos de Trabajo - Lan Gaiak Departamento de EconomÃa - Universidad PÃºblica de Navarra 1213, Departamento de Economía - Universidad Pública de Navarra.
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