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Means-tested complementary health insurance and healthcare utilisation in France: Evidence from a low-income population

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  • Wittwer, Jérôme
  • Guthmuller, Sophie
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    Abstract

    This paper assesses the impact of a free complementary health insurance plan introduced in 2000 in France on healthcare utilisation and healthcare expenditures. This free plan pays off most of out-of-pocket expenses and is entitled to the 10% poorest households in France. In order to tackle the endogeneity issue of the complementary health insurance variable, we use information on the selection rule to qualify for the free plan and adopt a regression discontinuity approach using eligibility (family income below the cut-off value) as an instrument variable. First findings show a significant effect of the free plan on the number of doctor visits, especially on the number of GP visits and on healthcare expenditures. However, we do not find any impact on the likelihood of seeing a doctor and on the number of specialist visits.

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    File URL: http://basepub.dauphine.fr/xmlui/bitstream/123456789/9533/1/Guthmuller&Wittwerjma.pdf
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    Bibliographic Info

    Paper provided by Université Paris-Dauphine in its series Open Access publications from Université Paris-Dauphine with number urn:hdl:123456789/9533.

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    Length: 21
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    Handle: RePEc:ner:dauphi:urn:hdl:123456789/9533

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    Web page: http://www.dauphine.fr/en/welcome.html

    Related research

    Keywords: Free health insurance; regression discontinuity design; low-income population; France;

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    References

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    1. Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219.
    2. Erich Battistin & Agar Brugiavini & Enrico Rettore & Guglielmo Weber, 2008. "The retirement consumption puzzle: evidence from a regression discontinuity approach," IFS Working Papers W08/05, Institute for Fiscal Studies.
    3. Hullegie P & Klein TJ, 2009. "The effect of private health insurance on medical care utilization and self-assessed health in Germany," Health, Econometrics and Data Group (HEDG) Working Papers 09/17, HEDG, c/o Department of Economics, University of York.
    4. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
    5. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687.
    6. David S. Lee & Thomas Lemieux, 2009. "Regression Discontinuity Designs in Economics," NBER Working Papers 14723, National Bureau of Economic Research, Inc.
    7. Guido Imbens & Thomas Lemieux, 2007. "Regression Discontinuity Designs: A Guide to Practice," NBER Working Papers 13039, National Bureau of Economic Research, Inc.
    8. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, MIT Press, vol. 124(2), pages 597-636, May.
    9. 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 2242-58, December.
    10. de la Mata, D;, 2011. "The Effect of Medicaid on Children's Health: A Regression Discontinuity Approach," Health, Econometrics and Data Group (HEDG) Working Papers 11/16, HEDG, c/o Department of Economics, University of York.
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