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Incentive effects in the demand for health care: a bivariate panel count data estimation

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Author Info
Andreas Million
Regina T. Riphahn
Achim Wambach

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Abstract

This paper contributes in three dimensions to the literature on health care demand. First, it features the first application of a bivariate random effects estimator in a count data setting, to permit the efficient estimation of this type of model with panel data. Second, it provides an innovative test of adverse selection and confirms that high-risk individuals are more likely to acquire supplemental add-on insurance. Third, the estimations yield that in accordance with the theory of moral hazard, we observe a much lower frequency of doctor visits among the self-employed, and among mothers of small children. Copyright © 2002 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/jae.680
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File URL: http://qed.econ.queensu.ca:80/jae/2003-v18.4/
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Journal of Applied Econometrics.

Volume (Year): 18 (2003)
Issue (Month): 4 ()
Pages: 387-405
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Handle: RePEc:jae:japmet:v:18:y:2003:i:4:p:387-405

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References listed on IDEAS
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.:
  1. Pierre-Andre Chiappori & Bernard Salanie, 2001. "Testing for Asymmetric Information in Insurance Markets," Journal of Political Economy, University of Chicago Press, vol. 108(1), pages 56-78, February. [Downloadable!] (restricted)
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  2. Coulson, N.E. & Terza, J. & Neslusan, C.A. & Stuart, B., 1995. "Estimating the Moral Hazard Effect of Supplemental Medical Insurance in the Demand for Prescription Drugs by the Elderly," Papers 04-95-01, Pennsylvania State - Department of Economics.
    Other versions:
  3. Alberto HOLLY & Lucien GARDIOL & Gianfranco DOMENIGHETTI & Brigitte BISIG, 1998. "An Econometric Model of Health Care Utilization and Health Insurance in Switzerland," Cahiers de Recherches Economiques du Département d'Econométrie et d'Economie politique (DEEP) 9803, Université de Lausanne, Faculté des HEC, DEEP.
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  4. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May. [Downloadable!] (restricted)
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  5. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr. [Downloadable!] (restricted)
  6. Jerry A. Hausman & Bronwyn H. Hall & Zvi Griliches, 1984. "Econometric Models for Count Data with an Application to the Patents-R&D Relationship," NBER Technical Working Papers 0017, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  7. Marquis, M. Susan, 1992. "Adverse selection with a multiple choice among health insurance plans: A simulation analysis," Journal of Health Economics, Elsevier, vol. 11(2), pages 129-151, August. [Downloadable!] (restricted)
  8. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June. [Downloadable!] (restricted)
  9. Cameron, A Colin & Trivedi, Pravin K, 1986. "Econometric Models Based on Count Data: Comparisons and Applications of Some Estimators and Tests," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 1(1), pages 29-53, January. [Downloadable!] (restricted)
  10. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
  11. Hausman, Jerry A, 1978. "Specification Tests in Econometrics," Econometrica, Econometric Society, vol. 46(6), pages 1251-71, November. [Downloadable!] (restricted)
  12. Altman, Daniel & Cutler, David M & Zeckhauser, Richard J, 1998. "Adverse Selection and Adverse Retention," American Economic Review, American Economic Association, vol. 88(2), pages 122-26, May. [Downloadable!] (restricted)
  13. Geil, Peter, et al, 1997. "Economic Incentives and Hospitalization in Germany," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 295-311, May-June. [Downloadable!]
  14. Cameron, A C & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Blackwell Publishing, vol. 55(1), pages 85-106, January. [Downloadable!] (restricted)
  15. Long, Stephen H. & Marquis, M. Susan & Rodgers, Jack, 1998. "Do people shift their use of health services over time to take advantage of insurance?," Journal of Health Economics, Elsevier, vol. 17(1), pages 105-115, January. [Downloadable!] (restricted)
  16. Ellis, Randall P, 1989. "Employee Choice of Health Insurance," The Review of Economics and Statistics, MIT Press, vol. 71(2), pages 215-23, May. [Downloadable!] (restricted)
  17. Marquis, M Susan & Phelps, Charles E, 1987. "Price Elasticity and Adverse Selection in the Demand for Supplementary Health Insurance," Economic Inquiry, Oxford University Press, vol. 25(2), pages 299-313, April.
  18. Hellwig, Martin F., 1988. "A note on the specification of interfirm communication in insurance markets with adverse selection," Journal of Economic Theory, Elsevier, vol. 46(1), pages 154-163, October. [Downloadable!] (restricted)
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Cited by:
(explanations, 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.)

  1. Hullegie, P & Klein, T. J, 2009. "The effect of private health insurance on medical care utilization and self-assessed health in Germany," Health, Econometrics and Data Group (HEDG) Working Papers 09/17, HEDG, c/o Department of Economics, University of York. [Downloadable!]
  2. Markus Jochmann & Roberto Leon-Gonzalez, 2003. "Estimating the Demand for Health Care with Panel Data: A Semiparametric Bayesian Approach," Working Papers 2003005, The University of Sheffield, Department of Economics, revised Oct 2003. [Downloadable!]
    Other versions:
  3. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724. [Downloadable!]
  4. William Greene, 2009. "Models for count data with endogenous participation," Empirical Economics, Springer, vol. 36(1), pages 133-173, February. [Downloadable!] (restricted)
  5. Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892. [Downloadable!]
  6. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Care Finance and Economics, Springer, vol. 9(1), pages 83-112, March. [Downloadable!] (restricted)
    Other versions:
  7. Y. Machnes, 2006. "The demand for private health care under national health insurance," The European Journal of Health Economics, Springer, vol. 7(4), pages 265-269, December. [Downloadable!] (restricted)
  8. Hendrik Schmitz, 2008. "Do Optional Deductibles Reduce the Number of Doctor Visits?: Empirical Evidence with German Data," SOEPpapers 141, DIW Berlin, The German Socio-Economic Panel (SOEP). [Downloadable!]
    Other versions:
  9. Teresa Bago d'Uva, 2006. "Latent class models for utilisation of health care," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 329-343. [Downloadable!]
  10. Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute. [Downloadable!]
    Other versions:
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