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Premium subsidies and social health insurance: Substitutes or complements?

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  • Kifmann, Mathias
  • Roeder, Kerstin

Abstract

Premium subsidies have been advocated as an alternative to social health insurance. These subsidies are paid if expenditure on health insurance exceeds a given share of income. In this paper, we examine whether this approach is superior to social health insurance from a welfare perspective. We show that the results crucially depend on the correlation of health and productivity. For a positive correlation, we find that combining premium subsidies with social health insurance is the optimal policy.

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  • Kifmann, Mathias & Roeder, Kerstin, 2011. "Premium subsidies and social health insurance: Substitutes or complements?," Journal of Health Economics, Elsevier, vol. 30(6), pages 1207-1218.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:6:p:1207-1218
    DOI: 10.1016/j.jhealeco.2011.08.007
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    1. Robin Boadway & Manuel Leite‐Monteiro & Maurice Marchand & Pierre Pestieau, 2006. "Social Insurance and Redistribution with Moral Hazard and Adverse Selection," Scandinavian Journal of Economics, Wiley Blackwell, vol. 108(2), pages 279-298, July.
    2. Diamond, P. A., 1975. "A many-person Ramsey tax rule," Journal of Public Economics, Elsevier, vol. 4(4), pages 335-342, November.
    3. Zweifel, Peter & Breuer, Michael, 2006. "The case for risk-based premiums in public health insurance," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 171-188, April.
    4. Jesus Seade, 1982. "On the Sign of the Optimum Marginal Income Tax," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 49(4), pages 637-643.
    5. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    6. Slemrod, Joel & Yitzhaki, Shlomo & Mayshar, Joram & Lundholm, Michael, 1994. "The optimal two-bracket linear income tax," Journal of Public Economics, Elsevier, vol. 53(2), pages 269-290, February.
    7. Gerdtham, Ulf-G. & Johannesson, Magnus, 2000. "Income-related inequality in life-years and quality-adjusted life-years," Journal of Health Economics, Elsevier, vol. 19(6), pages 1007-1026, November.
    8. MOSSIN, Jan, 1968. "Aspects of rational insurance purchasing," LIDAM Reprints CORE 23, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    9. Netzer, Nick & Scheuer, Florian, 2007. "Taxation, insurance, and precautionary labor," Journal of Public Economics, Elsevier, vol. 91(7-8), pages 1519-1531, August.
    10. Greenwood, Jeremy & Hercowitz, Zvi & Huffman, Gregory W, 1988. "Investment, Capacity Utilization, and the Real Business Cycle," American Economic Review, American Economic Association, vol. 78(3), pages 402-417, June.
    11. Zweifel, Peter & Breuer, Michael, 2006. "Reply to our critics," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 201-202, April.
    12. Stiglitz, Joseph E., 1982. "Self-selection and Pareto efficient taxation," Journal of Public Economics, Elsevier, vol. 17(2), pages 213-240, March.
    13. van de Ven, Wynand P. M. M. & van Vliet, Rene C. J. A. & Schut, Frederik T. & van Barneveld, Erik M., 2000. "Access to coverage for high-risks in a competitive individual health insurance market: via premium rate restrictions or risk-adjusted premium subsidies?," Journal of Health Economics, Elsevier, vol. 19(3), pages 311-339, May.
    14. Helmuth Cremer & Pierre Pestieau, 1996. "Redistributive taxation and social insurance," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 3(3), pages 281-295, July.
    15. Friedrich Breyer & Martin Heineck & Normann Lorenz, 2003. "Determinants of health care utilization by German sickness fund members ‐ with application to risk adjustment," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 367-376, May.
    16. Van De Ven, Wynand, 2006. "Response: The case for risk-based subsidies in public health insurance," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 195-199, April.
    17. Sheshinski, Eytan, 1989. "Note on the shape of the optimum income tax schedule," Journal of Public Economics, Elsevier, vol. 40(2), pages 201-215, November.
    18. Mcguire, Alistair, 2006. "Response: Is there a case for risk-based premiums in health care insurance?," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 189-193, April.
    19. Blomqvist, Ake & Horn, Henrik, 1984. "Public health insurance and optimal income taxation," Journal of Public Economics, Elsevier, vol. 24(3), pages 353-371, August.
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    Cited by:

    1. Nuscheler, Robert & Roeder, Kerstin, 2015. "Financing and funding health care: Optimal policy and political implementability," Journal of Health Economics, Elsevier, vol. 42(C), pages 197-208.
    2. Milstein, Ricarda & Schreyögg, Jonas, 2022. "Activity-based funding based on diagnosis-related groups: The end of an era? A review of payment reforms in the inpatient sector in ten high-income countries," hche Research Papers 28, University of Hamburg, Hamburg Center for Health Economics (hche).
    3. Indra Kurniawan, Muhammad, 2021. "Has access to health insurance through the Indonesian social security system improved peoples understanding of health issues? Evidence from a national survey," Warwick-Monash Economics Student Papers 14, Warwick Monash Economics Student Papers.
    4. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    5. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    6. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    7. Jan Brosse & Mathias Kifmann, 2013. "Competition in Health Insurance and Premium Regulation," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(1), pages 21-26, 04.
    8. Hofer, Florian & Birkner, Benjamin & Spindler, Martin, 2021. "Power of machine learning algorithms for predicting dropouts from a German telemonitoring program using standardized claims data," hche Research Papers 24, University of Hamburg, Hamburg Center for Health Economics (hche).
    9. Ousmane Traoré, 2021. "The relationship between health poverty and income poverty in Sub-Saharan African countries: evidence from index correlations," SN Business & Economics, Springer, vol. 1(10), pages 1-19, October.
    10. Mathias Kifmann & Kerstin Roeder, "undated". "Premium Subsidies and Social Insurance: Substitutes or Complements?," Working Papers 2011/01, Hamburg Center for Health Economics, University of Hamburg.
    11. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    12. Peter Zweifel, 2013. "The present state of health economics: a critique and an agenda for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 569-571, August.
    13. Jan Brosse & Mathias Kifmann, 2013. "Competition in Health Insurance and Premium Regulation," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(01), pages 21-26, April.
    14. repec:ces:ifodic:v:11:y:2013:i:1:p:19083487 is not listed on IDEAS

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    More about this item

    Keywords

    Social insurance; Health insurance; Redistributive taxation; Equity;
    All these keywords.

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • H5 - Public Economics - - National Government Expenditures and Related Policies
    • I1 - Health, Education, and Welfare - - Health

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