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The effect of private health insurance on medical care utilization and self‐assessed health in Germany

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Author Info

  • Patrick Hullegie
  • Tobias J. Klein

Abstract

In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance threshold. Here, premia are based on age and health, individuals may choose to what extent they are covered, and deductibles and co‐payments are common. In this paper, we estimate the effect of private insurance coverage on the number of doctor visits, the number of nights spent in a hospital and self‐assessed health. Variation in income around the compulsory insurance threshold provides a natural experiment that we exploit to control for selection into private insurance. We document that income is measured with error and suggest an approach to take this into account. We find negative effects of private insurance coverage on the number of doctor visits, no effects on the number of nights spent in a hospital, and positive effects on health. Copyright (C) 2010 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1642
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 19 (2010)
Issue (Month): 9 (September)
Pages: 1048-1062

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Handle: RePEc:wly:hlthec:v:19:y:2010:i:9:p:1048-1062

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

Related research

Keywords: private health insurance ; medical care utilization ; selection into insurance ; natural experiment ; regression discontinuity design ; measurement error ;

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References

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Citations

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Cited by:
  1. Christian Bünnings & Harald Tauchmann, 2013. "Who Opts Out of the Statutory Health Insurance? A Discrete Time Hazard Model for Germany," Ruhr Economic Papers 0458, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
  2. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2014. "The Effects of Access to Health Insurance for Informally Employed Individuals in Peru," IZA Discussion Papers 8213, Institute for the Study of Labor (IZA).
  3. Bonsang, Eric & Klein, Tobias J., 2012. "Retirement and subjective well-being," Journal of Economic Behavior & Organization, Elsevier, vol. 83(3), pages 311-329.
  4. Wittwer, Jérôme & Guthmuller, Sophie, 2012. "Means-tested complementary health insurance and healthcare utilisation in France: Evidence from a low-income population," Economics Papers from University Paris Dauphine 123456789/9533, Paris Dauphine University.
  5. Denise Doiron & Denzil G Fiebig & Agne Suziedelyte, 2013. "Hips and hearts: the variation in incentive effects of insurance across hospital procedures," Discussion Papers 2013-14, School of Economics, The University of New South Wales.
  6. Anikó Bíró, 2014. "Supplementary private health insurance and health care utilization of people aged 50+," Empirical Economics, Springer, vol. 46(2), pages 501-524, March.

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