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Planes Mínimos Obligatorios en Mercados de Seguros de Salud Segmentados

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Abstract

El trabajo analiza el efecto de la introducción de un plan mínimo obligatorio de prestaciones (PMO) que tanto el seguro público como los seguros privados deben cubrir. El análisis se realiza considerando la existencia de un mercado de seguros de salud segmentado en el sentido que, previo a la introducción del PMO, el seguro público sólo atiende a individuos de alto riesgo y los seguros privados sólo a individuos de riesgo bajo (la segmentación se obtiene de manera endógena en el modelo). Al caracterizar el equilibrio una vez que se introduce la reforma se puede constatar cómo la situación de los individuos de alto riesgo mejora en tanto que la de los de bajo riesgo empeora. La reforma introduce indirectamente un mecanismo de subsidios implícitos que otorgan cierta “solidaridad” al sistema, aun cuando la reforma no lo promueva de manera explícita mediante mecanismos de compensación de riesgos. Se demuestra que para que este mecanismo opere y la reforma tenga algún impacto es imprescindible que se regulen tanto el precio como la calidad asociados al PMO y que el regulador tenga la capacidad de hacer cumplir que los privados efectivamente tengan el PMO disponible para todos los tipos de asegurados.

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Bibliographic Info

Paper provided by Ilades-Georgetown University, Universidad Alberto Hurtado/School of Economics and Bussines in its series ILADES-Georgetown University Working Papers with number inv198.

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Length: 25 pages
Date of creation: Dec 2007
Date of revision:
Handle: RePEc:ila:ilades:inv198

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Keywords: seguros de salud; planes mínimos obligatorios; competencia administrada;

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  1. Askildsen, Jan Erik & Bratberg, Espen & Nilsen, Øivind Anti, 2002. "Unemployment, labour force composition and sickness absence. A panel data study," Working Papers in Economics 05/02, University of Bergen, Department of Economics.
  2. Ziebarth N & Karlsson M, 2009. "The effects of expanding the generosity of the statutory sickness insurance system," Health, Econometrics and Data Group (HEDG) Working Papers 09/35, HEDG, c/o Department of Economics, University of York.
  3. Georges Dionne & Benoit Dostie, 2005. "New Evidence on the Determinants of Absenteeism Using Linked Employer-Employee Data," Cahiers de recherche 0521, CIRPEE.
  4. Rigmar Osterkamp & Oliver Röhn, 2007. "Being on Sick Leave: Possible Explanations for Differences of Sick-leave Days Across Countries," CESifo Economic Studies, CESifo, vol. 53(1), pages 97-114, March.
  5. Nicolas R. Ziebarth & Martin Karlsson, 2009. "A Natural Experiment on Sick Pay Cuts, Sickness Absence, and Labor Costs," SOEPpapers on Multidisciplinary Panel Data Research 244, DIW Berlin, The German Socio-Economic Panel (SOEP).
  6. Maria De Paola & Valeria Pupo & Vincenzo Scoppa, 2009. "Absenteeism In The Italian Public Sector: The Effects Of Changes In Sick Leave Compensation," Working Papers 200916, Università della Calabria, Dipartimento di Economia, Statistica e Finanza (Ex Dipartimento di Economia e Statistica).
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