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China’s medical savings accounts: an analysis of the price elasticity of demand for health care

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  • Hao Yu

    (RAND Corporation)

Abstract

Although medical savings accounts (MSAs) have drawn intensive attention across the world for their potential in cost control, there is limited evidence of their impact on the demand for health care. This paper is intended to fill that gap. First, we built up a dynamic model of a consumer’s problem of utility maximization in the presence of a nonlinear price schedule embedded in an MSA. Second, the model was implemented using data from a 2-year MSA pilot program in China. The estimated price elasticity under MSAs was between −0.42 and −0.58, i.e., higher than that reported in the literature. The relatively high price elasticity suggests that MSAs as an insurance feature may help control costs. However, the long-term effect of MSAs on health costs is subject to further analysis.

Suggested Citation

  • Hao Yu, 2017. "China’s medical savings accounts: an analysis of the price elasticity of demand for health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 773-785, July.
  • Handle: RePEc:spr:eujhec:v:18:y:2017:i:6:d:10.1007_s10198-016-0827-9
    DOI: 10.1007/s10198-016-0827-9
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    as
    1. John Mullahy, 1998. "Much Ado About Two: Reconsidering Retransformation and the Two-Part Model in Health Economics," NBER Technical Working Papers 0228, National Bureau of Economic Research, Inc.
    2. Yip, Winnie & Hsiao, William C., 2009. "Non-evidence-based policy: How effective is China's new cooperative medical scheme in reducing medical impoverishment?," Social Science & Medicine, Elsevier, vol. 68(2), pages 201-209, January.
    3. Feldman Roger D & Parente Stephen T, 2010. "Enrollee Incentives in Consumer Directed Health Plans: Spend Now or Save for Later?," Forum for Health Economics & Policy, De Gruyter, vol. 13(2), pages 1-20, April.
    4. Randall P. Ellis, 1986. "Rational Behavior in the Presence of Coverage Ceilings and Deductibles," RAND Journal of Economics, The RAND Corporation, vol. 17(2), pages 158-175, Summer.
    5. Haviland Amelia M & Sood Neeraj & McDevitt Roland & Marquis M Susan, 2011. "How Do Consumer-Directed Health Plans Affect Vulnerable Populations?," Forum for Health Economics & Policy, De Gruyter, vol. 14(2), pages 1-25, April.
    6. M. Kate Bundorf, 2016. "Consumer-Directed Health Plans: A Review Of The Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 83(1), pages 9-41, January.
    7. Anthony T. Lo Sasso & Lorens A. Helmchen & Robert Kaestner, 2010. "The Effects of Consumer‐Directed Health Plans on Health Care Spending," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 85-103, March.
    8. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
    9. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
    10. Wouters, Olivier J. & Cylus, Jonathan & Yang, Wei & Thomson, Sarah & McKee, Martin, 2016. "Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care," Health Economics, Policy and Law, Cambridge University Press, vol. 11(3), pages 321-335, July.
    11. Garber, Alan M. & Phelps, Charles E., 1997. "Economic foundations of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 1-31, February.
    12. Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845, Elsevier.
    13. JunQiang Liu & Tao Chen, 2013. "Sleeping money: investigating the huge surpluses of social health insurance in China," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 319-331, December.
    14. Keeler, Emmett B & Newhouse, Joseph P & Phelps, C E, 1977. "Deductibles and the Demand for Medical Care Services: The Theory of a Consumer Facing a Variable Price Schedule under Uncertainty," Econometrica, Econometric Society, vol. 45(3), pages 641-655, April.
    15. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, March.
    16. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    17. Wouters, Olivier J. & Cylus, Jonathan & Yang, Wei & Thomson, Sarah & McKee, Martin, 2016. "Medical savings accounts: assessing their impact on efficiency, equity, and financial protection in health care," LSE Research Online Documents on Economics 65448, London School of Economics and Political Science, LSE Library.
    18. Blough, David K. & Madden, Carolyn W. & Hornbrook, Mark C., 1999. "Modeling risk using generalized linear models," Journal of Health Economics, Elsevier, vol. 18(2), pages 153-171, April.
    19. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    20. Ai, Chunrong & Norton, Edward C., 2000. "Standard errors for the retransformation problem with heteroscedasticity," Journal of Health Economics, Elsevier, vol. 19(5), pages 697-718, September.
    21. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
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    Cited by:

    1. Wen He, 2022. "Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 7-22, February.

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    More about this item

    Keywords

    Medical savings accounts; Health insurance; Nonlinear price schedule; Elasticity; Demand for health care; China;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • N35 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Asia including Middle East

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