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Separating Selection and Incentive Effects: an Econometric Study of Swiss Health Insurance Claims Data

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  • Lucien Gardiol
  • Pierre-Yves Geoffard
  • Chantal Grandchamp

Abstract

This paper presents an empirical analysis of the link between health insurance coverage and health care expenditures. We use claims data for over 60 000 adult individuals covered by a major Swiss Health Insurance Fund, followed for up to four years. In the Swiss health insurance system, each individual can choose between five plans, corresponding to different levels of annual deductible. The data show a strong positive correlation between coverage and expenditure. We provide a simple method to separate selection effects (due to individual choice of coverage) and incentive effects ("�moral hazard�"). The method only requires that there exists an observable variable: 1. correlated with the unobservable health status; 2. not affected by incentives. The analysis of mortality rates indicates important selection effects, which is confirmed by the data on inpatient care. However, the positive correlation between coverage and outpatient expenditure is not fully explained by selection effects, and moral hazard effects are of the same order of magnitude.

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Bibliographic Info

Paper provided by DELTA (Ecole normale supérieure) in its series DELTA Working Papers with number 2003-27.

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Date of creation: 2003
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Handle: RePEc:del:abcdef:2003-27

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Cited by:
  1. Gardiol, Lucien & Geoffard, Pierre-Yves & Grandchamp, Chantal, 2005. "Separating Selection and Incentive Effects in Health Insurance," CEPR Discussion Papers 5380, C.E.P.R. Discussion Papers.
  2. World Bank, 2009. "Europe and Central Asia - Health insurance and competition," World Bank Other Operational Studies 3064, The World Bank.
  3. Pau Olivella & Marcos Vera-Hernández, 2006. "Testing for Asymmetric Information in Private Health Insurance," Working Papers 246, Barcelona Graduate School of Economics.

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