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Does free supplementary health insurance help the poor to access health care? Evidence from France

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Author Info
Michel Grignon () (Department of Economics, Centre for Gerontological Studies, Centre for Health Economics and Policy Analysis, McMaster University)
Marc Perronnin (Institut de recherche et de documentation en économie de la santé (IRDES), Paris, France)
John N. Lavis (Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, Department of Political Science, McMaster University)

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Abstract

The French government introduced a "free supplementary health insurance plan" in 2000, which covers most of the out-of-pocket payments faced by the poorest 10% of French residents. This plan was designed to help the non-elderly poor to access health care. To assess the impact of the introduction of the plan on its beneficiaries, we use a longitudinal dataset to compare, for the same individual, the evolution of his/her expenditures before and after enrolment in the plan. This longitudinal analysis allows us to remove most of the spuriousness due to individual heterogeneity, and we also use information on past coverage to evaluate the impact of specific benefits associated with the plan. As a result, we can properly assess the impact of the plan on those who enrolled in it. However, we cannot assess the impact of the plan on all of those who were eligible to enrol. Our main result is the plan’s lack of an overall effect on utilization. This result is likely attributable to the fact that those who were enrolled automatically in the free plan (the majority of enrollees), already benefited from a relatively generous plan. The significant effect among those who enrolled voluntarily in the free plan was likely driven by those with no previous supplemental coverage.

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File URL: http://www.chepa.org/Portals/0/pdf/CHEPA%20WP%2006-02.pdf
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File Function: First Version, 2006
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Publisher Info
Paper provided by Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada in its series Centre for Health Economics and Policy Analysis Working Paper Series with number 06-02.

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Length: 39 pages
Date of creation: 2006
Date of revision:
Handle: RePEc:hpa:wpaper:0602

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Postal: Faculty of Health Sciences, Mc Master University, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5
Phone: (905) 525-9140, extension 22122
Fax: (905) 546-5211
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Web page: http://www.chepa.org/
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Related research
Keywords: health care financing equity and inequalities health care systems health insurance natural experiment

Find related papers by JEL classification:
I38 - Health, Education, and Welfare - - Welfare and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

References listed on IDEAS
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. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471. [Downloadable!]
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