IDEAS home Printed from https://ideas.repec.org/a/seg/012016/v1y2017i2p109-132.html
   My bibliography  Save this article

Evidence About The Moral Hazard In The Ecuadorian Health System

Author

Listed:
  • Mercy Raquel Orellana Bravo

    (University of Cuenca; Research Group in Regional Economics)

  • Juan Andrés Piedra Peña

    (University of Cuenca; Research Group in Regional Economics)

  • Luis Santiago Sarmiento Moscoso

    (University of Cuenca; Research Group in Regional Economics)

Abstract

The aim of this study is to estimate the presence of moral hazard in the Ecuadorian health system, understood as an over-utilization of it. For this, a binomial logit model, which measures the probability of use of health services between insured and uninsured people is used. The results show evidence of moral hazard for individuals who are insured, mainly for adults over 60 years. In addition, it is noted that when having extra expenses that are not covered by insurance, insured people tend to reduce the use of medical services.

Suggested Citation

  • Mercy Raquel Orellana Bravo & Juan Andrés Piedra Peña & Luis Santiago Sarmiento Moscoso, 2017. "Evidence About The Moral Hazard In The Ecuadorian Health System," Journal of Smart Economic Growth, , vol. 2(1), pages 109-132, March.
  • Handle: RePEc:seg:012016:v:1:y:2017:i:2:p:109-132
    as

    Download full text from publisher

    File URL: https://jseg.ro/index.php/jseg/article/view/13/13
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. Keane, Michael & Stavrunova, Olena, 2016. "Adverse selection, moral hazard and the demand for Medigap insurance," Journal of Econometrics, Elsevier, vol. 190(1), pages 62-78.
    3. 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 251-277, June.
    4. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    5. Patrick Bajari & Christina Dalton & Han Hong & Ahmed Khwaja, 2014. "Moral hazard, adverse selection, and health expenditures: A semiparametric analysis," RAND Journal of Economics, RAND Corporation, vol. 45(4), pages 747-763, December.
    6. Sapelli, Claudio & Vial, Bernardita, 2003. "Self-selection and moral hazard in Chilean health insurance," Journal of Health Economics, Elsevier, vol. 22(3), pages 459-476, May.
    7. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
    8. Sindelar, Jody L, 1982. "Differential Use of Medical Care by Sex," Journal of Political Economy, University of Chicago Press, vol. 90(5), pages 1003-1019, October.
    9. Michael Rothschild & Joseph Stiglitz, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 90(4), pages 629-649.
    10. Van de Ven, Wynand P. M. M. & Van Praag, Bernard M. S., 1981. "The demand for deductibles in private health insurance : A probit model with sample selection," Journal of Econometrics, Elsevier, vol. 17(2), pages 229-252, November.
    11. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    12. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Juan Piedra-Peña & Diego Prior, 2023. "Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 361-392, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    2. Dardanoni, Valentino & Li Donni, Paolo, 2012. "Incentive and selection effects of Medigap insurance on inpatient care," Journal of Health Economics, Elsevier, vol. 31(3), pages 457-470.
    3. Sengupta, Reshmi & Rooj, Debasis, 2019. "The effect of health insurance on hospitalization: Identification of adverse selection, moral hazard and the vulnerable population in the Indian healthcare market," World Development, Elsevier, vol. 122(C), pages 110-129.
    4. Preety Srivastava & Gang Chen & Anthony Harris, 2017. "Oral Health, Dental Insurance and Dental Service use in Australia," Health Economics, John Wiley & Sons, Ltd., vol. 26(1), pages 35-53, January.
    5. Keane, Michael & Stavrunova, Olena, 2016. "Adverse selection, moral hazard and the demand for Medigap insurance," Journal of Econometrics, Elsevier, vol. 190(1), pages 62-78.
    6. Lan Nguyen & Andrew C. Worthington, 2023. "Moral hazard in Australian private health insurance: the case of dental care services and extras cover," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 157-176, January.
    7. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    8. Ha Trong Nguyen & Luke B Connelly, 2017. "Cost-sharing in health insurance and its impact in a developing country: evidence from a quasi-natural experiment," Bankwest Curtin Economics Centre Working Paper series WP1702, Bankwest Curtin Economics Centre (BCEC), Curtin Business School.
    9. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    10. De La Mata, Dolores & Machado, Matilde P. & Olivella, Pau & Valdés, Maria Nieves, 2022. "Asymmetric Information with multiple risks: the case of the Chilean Private Health Insurance Market," UC3M Working papers. Economics 35441, Universidad Carlos III de Madrid. Departamento de Economía.
    11. Powell, David & Goldman, Dana, 2021. "Disentangling moral hazard and adverse selection in private health insurance," Journal of Econometrics, Elsevier, vol. 222(1), pages 141-160.
    12. Lim, Jae-Young, 2010. "De-mystifying the Inconvenient Truth : Does Ex Post Moral Hazard Indeed Exist in Korean Private Health Insurance Market?," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 51(2), pages 74-92, December.
    13. Andreas Million & Regina T. Riphahn & Achim Wambach, 2003. "Incentive effects in the demand for health care: a bivariate panel count data estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(4), pages 387-405.
    14. Ricardo Henriquez Hofter, 2006. "Private health insurance and utilization of health services in Chile," Applied Economics, Taylor & Francis Journals, vol. 38(4), pages 423-439.
    15. Xiaoqi Zhang & Yi Chen & Yi Yao, 2021. "Dynamic information asymmetry in micro health insurance: implications for sustainability," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 46(3), pages 468-507, July.
    16. Barros, Pedro Pita & Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2008. "Moral hazard and the demand for health services: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 27(4), pages 1006-1025, July.
    17. Jan Michael Bauer & Jörg Schiller & Christopher Schreckenberger, 2020. "Heterogeneous selection in the market for private supplemental dental insurance: evidence from Germany," Empirical Economics, Springer, vol. 59(1), pages 205-231, July.
    18. Ángel Marcos Vera‐Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598, November.
    19. Rong Fu & Haruko Noguchi, 2019. "Moral hazard under zero price policy: evidence from Japanese long-term care claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 785-799, August.
    20. Patrick Bajari & Han Hong & Ahmed Khwaja, 2006. "Moral Hazard, Adverse Selection and Health Expenditures: A Semiparametric Analysis," NBER Working Papers 12445, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    Moral Hazard; asymmetric information; health insurance; health system; health services;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:seg:012016:v:1:y:2017:i:2:p:109-132. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Radu Lixandroiu (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.