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Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data

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  • Dunn, Abe

Abstract

This paper takes a different approach to estimating demand for medical care that uses the negotiated prices between insurers and providers as an instrument. The instrument is viewed as a textbook “cost shifting” instrument that impacts plan offerings, but is unobserved by consumers. The paper finds a price elasticity of demand of around −0.20, matching the elasticity found in the RAND Health Insurance Experiment. The paper also studies within-market variation in demand for prescription drugs and other medical care services and obtains comparable price elasticity estimates.

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  • Dunn, Abe, 2016. "Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data," Journal of Health Economics, Elsevier, vol. 48(C), pages 74-88.
    • Handle: RePEc:eee:jhecon:v:48:y:2016:i:c:p:74-88
    DOI: 10.1016/j.jhealeco.2016.03.001
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    Cited by:

    1. Osmani, Ahmad Reshad & Okunade, Albert, 2021. "A Double-Hurdle Model of Healthcare Expenditures across Income Quintiles and Family Size: New Insights from a household Survey," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 14(6), pages 246-246.
    2. Anne E. Hall, 2015. "Regional Patterns in Medical Technology Utilization," BEA Working Papers 0126, Bureau of Economic Analysis.
    3. He, Wen, 2023. "Social medical insurance integration and health care disparities in China: Evidence from an administrative claim dataset," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 20-39.
    4. Alex Hoagland & David M. Anderson & Ed Zhu, 2022. "Medical Bill Shock and Imperfect Moral Hazard," Papers 2211.01116, arXiv.org, revised Mar 2024.
    5. Huan Liu & Weidong Dai, 2020. "An Empirical Study on the Benefits Equity of the Medical Security Policy: the China Health and Nutrition Survey (CHNS)," IJERPH, MDPI, vol. 17(4), pages 1-17, February.
    6. Mikko Nurminen, 2021. "Mergers and Acquisitions in the Markets for Diagnostic Services: Evidence from the Finnish Private Health Care Sector," Discussion Papers 139, Aboa Centre for Economics.
    7. Dunn, Abe & Shapiro, Adam Hale & Liebman, Eli, 2013. "Geographic variation in commercial medical-care expenditures: A framework for decomposing price and utilization," Journal of Health Economics, Elsevier, vol. 32(6), pages 1153-1165.
    8. Ghosh, Ausmita & Simon, Kosali & Sommers, Benjamin D., 2019. "The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults:Evidence from Recent Medicaid Expansions," Journal of Health Economics, Elsevier, vol. 63(C), pages 64-80.
    9. Dillender, Marcus, 2018. "What happens when the insurer can say no? Assessing prior authorization as a tool to prevent high-risk prescriptions and to lower costs," Journal of Public Economics, Elsevier, vol. 165(C), pages 170-200.

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    More about this item

    Keywords

    Medical care demand; Price elasticity; Insurance claims; Instrumental variable; Commercial health insurance;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation

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