Why it may hurt to be insured: the effects of capping coinsurance payments
AbstractMost health insurance schemes use some sort of cost sharing to curb the moral hazard that is inherent to insurance. It is common to limit this cost sharing, by applying a deductible or a stop loss, for example. This can be motivated from an insurance perspective: without a cap, coinsurance payments might be unacceptably high for people with high medical costs. This paper shows that introducing a cap on coinsurance payments may actually hurt people with high medical costs. This is not due to moral hazard that comes along with the extra insurance. Instead, it is because the introduction of a cap makes health spending below the cap more price elastic, thereby inducing the health insurer to raise the coinsurance rate. Keywords: Moral Hazard, Deductibles, Co-Payment Schemes in Health Care, Idiosyncratic Health Shocks
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Bibliographic InfoPaper provided by CPB Netherlands Bureau for Economic Policy Analysis in its series CPB Discussion Paper with number 239.
Date of creation: Mar 2013
Date of revision:
Find related papers by JEL classification:
- D60 - Microeconomics - - Welfare Economics - - - General
- H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-2013-04-13 (All new papers)
- NEP-HEA-2013-04-13 (Health Economics)
- NEP-IAS-2013-04-13 (Insurance Economics)
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- Amanda E. Kowalski, 2012. "Estimating the Tradeoff Between Risk Protection and Moral Hazard with a Nonlinear Budget Set Model of Health Insurance," NBER Working Papers 18108, National Bureau of Economic Research, Inc.
- Robert E. Hall & Charles I. Jones, 2005.
"The value of life and the rise in health spending,"
Federal Reserve Bank of San Francisco.
- Amitabh Chandra & Jonathan Gruber & Robin McKnight, 2012. "The Impact of Patient Cost-Sharing on the Poor: Evidence from Massachusetts," NBER Working Papers 18023, National Bureau of Economic Research, Inc.
- Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
- Daniel Feenberg & Jonathan Skinner, 1992.
"The Risk and Duration of Catastrophic Health Care Expenditures,"
NBER Working Papers
4147, National Bureau of Economic Research, Inc.
- Feenberg, Daniel & Skinner, Jonathan, 1994. "The Risk and Duration of Catastrophic Health Care Expenditures," The Review of Economics and Statistics, MIT Press, vol. 76(4), pages 633-47, November.
- Ellis, Randall P. & Manning, Willard G., 2007. "Optimal health insurance for prevention and treatment," Journal of Health Economics, Elsevier, vol. 26(6), pages 1128-1150, December.
- 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.
- Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
- Feldstein, Martin S, 1973. "The Welfare Loss of Excess Health Insurance," Journal of Political Economy, University of Chicago Press, vol. 81(2), pages 251-80, Part I, M.
- Gary V. Engelhardt & Jonathan Gruber, 2010. "Medicare Part D and the Financial Protection of the Elderly," NBER Working Papers 16155, National Bureau of Economic Research, Inc.
- Blomqvist, Ake, 1997. "Optimal non-linear health insurance," Journal of Health Economics, Elsevier, vol. 16(3), pages 303-321, June.
- Amitabh Chandra & Jonathan S. Skinner, 2011.
"Technology Growth and Expenditure Growth in Health Care,"
NBER Working Papers
16953, National Bureau of Economic Research, Inc.
- Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-80, September.
- Manning, Willard G. & Marquis, M. Susan, 1996. "Health insurance: The tradeoff between risk pooling and moral hazard," Journal of Health Economics, Elsevier, vol. 15(5), pages 609-639, October.
- Phelps, Charles E & Newhouse, Joseph P, 1974. "Coinsurance, the Price of Time, and the Demand for Medical Services," The Review of Economics and Statistics, MIT Press, vol. 56(3), pages 334-42, August.
- 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 115-26, April.
- Getzen, Thomas E., 2000. "Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures," Journal of Health Economics, Elsevier, vol. 19(2), pages 259-270, March.
- Wedig, Gerard J., 1988. "Health status and the demand for health : Results on price elasticities," Journal of Health Economics, Elsevier, vol. 7(2), pages 151-163, June.
- 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 641-55, April.
- C. J. A. Van Vliet Rene, 2001. "Effects of price and deductibles on medical care demand, estimated from survey data," Applied Economics, Taylor & Francis Journals, vol. 33(12), pages 1515-1524.
- Eric French & John Bailey Jones, 2004. "On the distribution and dynamics of health care costs," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(6), pages 705-721.
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