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Access to physician services: does supplemental insurance matter? Evidence from France

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Author Info
Thomas C. Buchmueller
Agnès Couffinhal (Centre de Recherche d'Etudes et de Documentation en Economie de la Santé, Paris, France)
Michel Grignon (Centre de Recherche d'Etudes et de Documentation en Economie de la Santé, Paris, France)
Marc Perronnin (Centre de Recherche d'Etudes et de Documentation en Economie de la Santé, Paris, France)

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Abstract

In France, public health insurance is universal but incomplete, with private payments accounting for roughly 25% of all spending. As a result, most people have supplemental private health insurance. We investigate the effects of such insurance on the utilization of physician services using data from the 1998 Enquête sur la santé et la protection sociale, a nationally representative survey of the non-institutionalized French population. Our results indicate that insurance has a strong and significant effect on the utilization of physician services. Individuals with supplemental coverage have substantially more physician visits than those without. While French patients have greater freedom than patients in other countries to choose to see a specialist rather than a general practitioner, we find no evidence that supplemental insurance affects this decision. Copyright © 2004 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.879
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 13 (2004)
Issue (Month): 7 ()
Pages: 669-687
Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
Handle: RePEc:wly:hlthec:v:13:y:2004:i:7:p:669-687

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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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. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456. [Downloadable!]
  2. 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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  3. 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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  4. 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)
  5. Ettner, Susan L., 1997. "Adverse selection and the purchase of Medigap insurance by the elderly," Journal of Health Economics, Elsevier, vol. 16(5), pages 543-562, October. [Downloadable!] (restricted)
  6. Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April. [Downloadable!] (restricted)
  7. Cartwright, William S & Hu, Teh-Wei & Huang, Lien-Fu, 1992. "Impact of Varying Medigap Insurance Coverage on the Use of Medical Services of the Elderly," Applied Economics, Taylor and Francis Journals, vol. 24(5), pages 529-39, May.
  8. Amir Shmueli, 2001. "The effect of health on acute care supplemental insurance ownership: an empirical analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 341-350. [Downloadable!]
  9. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145. [Downloadable!]
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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. Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219. [Downloadable!]
  2. Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI). [Downloadable!]
  3. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income-related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608. [Downloadable!]
  4. Alka Chadha & Åke Blomqvist, 2005. "Patent Races, “Me-Too” Drugs, and Generics: A Developing-World Perspective," Departmental Working Papers wp0513, National University of Singapore, Department of Economics. [Downloadable!]
  5. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI). [Downloadable!]
  6. Lien Nguyen & Unto Häkkinen, 2006. "Choices and utilization in dental care," The European Journal of Health Economics, Springer, vol. 7(2), pages 99-106, June. [Downloadable!] (restricted)
  7. Randall Ellis & Elizabeth Savage, 2008. "Run for cover now or later? The impact of premiums, threats and deadlines on private health insurance in Australia," International Journal of Health Care Finance and Economics, Springer, vol. 8(4), pages 257-277, December. [Downloadable!] (restricted)
  8. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060. [Downloadable!]
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  9. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334. [Downloadable!]
  10. D. Fabbri & C. Monfardini & R. Radice, 2004. "Testing exogeneity in the bivariate probit model: Monte Carlo evidence and an application to health economics," Working Papers 514, Dipartimento Scienze Economiche, Universita' di Bologna. [Downloadable!]
  11. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI). [Downloadable!]
  12. Martine M. Bellanger & Philippe R. Mossé, 2005. "The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S119-S132. [Downloadable!]
  13. Francesca Barigozzi, 2006. "Supplementary Insurance with 'ex post' moral hazard: efficiency and redistribution," Annales d'Economie et de Statistique, ADRES, issue 83-84, pages 12, Juillet-D. [Downloadable!]
    Other versions:
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