The political economics of social health insurance: the tricky case of individuals’ preferences
AbstractSocial health insurance systems can be designed with different levels of state involvement and varying degrees of redistribution. In this article we focus on citizens’ preferences regarding the design of their health insurance coverage including the extent of redistribution. Using a microeconomic model we hypothesize that the individual’s preferred options are determined by the relative income position and the relative risk of falling ill. Only individuals who expect to realize a net profit through the implicit redistributive transfers will favour a public insurance coverage over a private one. We test this hypothesis empirically using three dis-tinct approaches. The first two are based on survey questions focusing on the type of coverage and the degree of redistribution respectively. The third is based on a discrete choice experiment thus accounting for trade-offs and budget constraints. The data is from a representative sample of 1.538 German individuals who were surveyed and participated in the DCE in early 2012. We find that the model has to be rejected. There is a wide consensus that redistributive elements should be an integral part of the social health insurance system and could even be extended. However, there are also preferences for health insurance coverage that can be individually optimized.
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Bibliographic InfoPaper provided by University Library of Munich, Germany in its series MPRA Paper with number 44534.
Date of creation: Feb 2013
Date of revision:
social health insurance; preferences; discrete choice experiment;
Find related papers by JEL classification:
- C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
- H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
- H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
- I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
This paper has been announced in the following NEP Reports:
- NEP-ALL-2013-03-16 (All new papers)
- NEP-DCM-2013-03-16 (Discrete Choice Models)
- NEP-HEA-2013-03-16 (Health Economics)
- NEP-IAS-2013-03-16 (Insurance Economics)
- NEP-POL-2013-03-16 (Positive Political Economics)
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