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Risky health decisions under regulatory constraints: Abortion tourism in Switzerland

Author

Listed:
  • Annette Hofmann

    (St. John’s University)

  • Julia K. Neumann

    (University of Hamburg)

  • Peter Zweifel

    (University of Zurich)

Abstract

This study provides both a behavioral model and empirical evidence on the risky search for a health service across jurisdictions that differ in their regulatory policies. The health service in question is a particularly sensitive one, an abortion, and the jurisdictions are the 26 cantons of Switzerland. Using Swiss health insurance data, theoretical predictions are confirmed to a considerable degree: (1) Women who derive a particularly high benefit from an abortion (and concealing it) are less discouraged by strict local enforcement than others; (2) A substantial share of abortions may be concealed by contrived medical coding, and (3) Conservative cantons with a preference for stringent implementation of federal abortion regulation export the problem to more liberal ones, resulting in preference-based migration. The analysis implies a difficult trade-off for policy: To curtail abortion tourism, the cantons would have to be mandated to implement the pertinent federal regulation in a uniform way; this would, however, neglect important regional differences in preferences.

Suggested Citation

  • Annette Hofmann & Julia K. Neumann & Peter Zweifel, 2019. "Risky health decisions under regulatory constraints: Abortion tourism in Switzerland," Journal of Risk and Uncertainty, Springer, vol. 59(3), pages 203-237, December.
    • Handle: RePEc:kap:jrisku:v:59:y:2019:i:3:d:10.1007_s11166-019-09319-z
    DOI: 10.1007/s11166-019-09319-z
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