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The effects of private versus public health insurance on health and labor market outcomes

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  • Dauth, Christine

    (Institute for Employment Research (IAB), Nuremberg, Germany)

Abstract

Among health care systems with both public and private elements (such as in the US and Germany), an important question is whether the type of health insurance exerts an impact on workers’ careers. We exploit the unique German case of a two-tier health care system to analyze whether opting out of public statutory health insurance and into private health insurance affects the specific health and employment outcomes of employed workers over a period of nine years. We exploit administrative registers and apply a fuzzy regression discontinuity design. We do not find any evidence that the type of health insurance affects employed workers’ outcomes in the medium or long run. This suggests that even though private health insurance entails more comfortable healthcare conditions, public health insurance does not come with heavy health impairments or detrimental employment outcomes." (Author's abstract, IAB-Doku) ((en))

Suggested Citation

  • Dauth, Christine, 2021. "The effects of private versus public health insurance on health and labor market outcomes," IAB-Discussion Paper 202103, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
  • Handle: RePEc:iab:iabdpa:202103
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    References listed on IDEAS

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    1. Patrick Hullegie & Tobias J. Klein, 2010. "The effect of private health insurance on medical care utilization and self‐assessed health in Germany," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1048-1062, September.
    2. Martina Grunow & Robert Nuscheler, 2014. "Public And Private Health Insurance In Germany: The Ignored Risk Selection Problem," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 670-687, June.
    3. Dominic Coey, 2015. "Physicians' financial incentives and treatment choices in heart attack management," Quantitative Economics, Econometric Society, vol. 6(3), pages 703-748, November.
    4. Halla, Martin & Zweimüller, Martina, 2013. "The effect of health on earnings: Quasi-experimental evidence from commuting accidents," Labour Economics, Elsevier, vol. 24(C), pages 23-38.
    5. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    6. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    7. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    8. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust data-driven inference in the regression-discontinuity design," Stata Journal, StataCorp LP, vol. 14(4), pages 909-946, December.
    9. René Petilliot, 2017. "The Effect of Private Health Insurance on Self-assessed Health Status and Health Satisfaction in Germany," SOEPpapers on Multidisciplinary Panel Data Research 917, DIW Berlin, The German Socio-Economic Panel (SOEP).
    10. Christian Bünnings & Harald Tauchmann, 2015. "Who Opts out of the Statutory Health Insurance? A Discrete Time Hazard Model for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1331-1347, October.
    11. Paul Frijters & David W. Johnston & Michael A. Shields, 2014. "The Effect Of Mental Health On Employment: Evidence From Australian Panel Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 1058-1071, September.
    12. Alexander, Diane & Currie, Janet, 2017. "Are publicly insured children less likely to be admitted to hospital than the privately insured (and does it matter)?," Economics & Human Biology, Elsevier, vol. 25(C), pages 33-51.
    13. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    14. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    15. Petilliot, René, 2017. "The effect of private health insurance on self-assessed health status and health satisfaction in Germany," FZG Discussion Papers 65, University of Freiburg, Research Center for Generational Contracts (FZG).
    16. Brown, L.D., 2003. "Comparing health systems in four countries: Lessons for the United States," American Journal of Public Health, American Public Health Association, vol. 93(1), pages 52-56.
    17. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    18. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    19. Andreas Million & Regina T. Riphahn & Achim Wambach, 2003. "Incentive effects in the demand for health care: a bivariate panel count data estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(4), pages 387-405.
    20. Hahn, Jinyong & Todd, Petra & Van der Klaauw, Wilbert, 2001. "Identification and Estimation of Treatment Effects with a Regression-Discontinuity Design," Econometrica, Econometric Society, vol. 69(1), pages 201-209, January.
    21. Antoni, Manfred & Ganzer, Andreas & Vom Berge, Philipp, 2019. "Sample of Integrated Labour Market Biographies Regional File (SIAB-R) 1975 - 2017," FDZ Datenreport. Documentation on Labour Market Data 201904_en, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    22. Jacob Goldin & Ithai Z Lurie & Janet McCubbin, 0. "Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach," The Quarterly Journal of Economics, Oxford University Press, vol. 136(1), pages 1-49.
    23. Polyakova, Maria, 2016. "Risk selection and heterogeneous preferences in health insurance markets with a public option," Journal of Health Economics, Elsevier, vol. 49(C), pages 153-168.
    24. Zagorsky, Jay L. & Smith, Patricia K., 2020. "Who drinks soda pop? Economic status and adult consumption of sugar-sweetened beverages," Economics & Human Biology, Elsevier, vol. 38(C).
    25. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    26. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
    27. Geil, Peter, et al, 1997. "Economic Incentives and Hospitalization in Germany," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 295-311, May-June.
    28. Antoni, Manfred & Schmucker, Alexandra & Seth, Stefan & Vom Berge, Philipp, 2019. "Sample of integrated labour market biographies (SIAB) 1975-2017," FDZ Datenreport. Documentation on Labour Market Data 201902_en, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    29. Diane Alexander & Molly Schnell, 2019. "The Impacts of Physician Payments on Patient Access, Use, and Health," NBER Working Papers 26095, National Bureau of Economic Research, Inc.
    30. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    31. Pilar García-Gómez & Hans van Kippersluis & Owen O’Donnell & Eddy van Doorslaer, 2013. "Long-Term and Spillover Effects of Health Shocks on Employment and Income," Journal of Human Resources, University of Wisconsin Press, vol. 48(4), pages 873-909.
    32. Jacob Goldin & Ithai Z Lurie & Janet McCubbin, 2021. "Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(1), pages 1-49.
    33. Matias D. Cattaneo & Nicolas Idrobo & Rocio Titiunik, 2019. "A Practical Introduction to Regression Discontinuity Designs: Foundations," Papers 1911.09511, arXiv.org.
    34. Matias D. Cattaneo & Michael Jansson & Xinwei Ma, 2018. "Manipulation testing based on density discontinuity," Stata Journal, StataCorp LP, vol. 18(1), pages 234-261, March.
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    More about this item

    Keywords

    Bundesrepublik Deutschland ; Auswirkungen ; Berufserfolg ; Berufsverlauf ; Fehlzeiten ; gesetzliche Krankenversicherung ; Gesundheitszustand ; IAB-Beschäftigtenhistorik ; Krankheit ; medizinische Versorgung ; private Krankenversicherung ; Qualität ; 2000-2017;
    All these keywords.

    JEL classification:

    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure
    • J30 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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