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The political economics of social health insurance: the tricky case of individuals’ preferences

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  • Pfarr, Christian
  • Schmid, Andreas

Abstract

Social 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 Info

Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 44534.

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Date of creation: Feb 2013
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Handle: RePEc:pra:mprapa:44534

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Keywords: social health insurance; preferences; discrete choice experiment;

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  1. Marquis, M Susan & Holmer, Martin R, 1996. "Alternative Models of Choice under Uncertainty and Demand for Health Insurance," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 421-27, August.
  2. Breyer, Friedrich, 1995. "The Political Economy of Rationing in Social Health Insurance," Journal of Population Economics, Springer, vol. 8(2), pages 137-48, May.
  3. Lothar Essig & Joachim Winter, 2003. "Item nonresponse to financial questions in household surveys: An experimental study of interviewer and mode effects," MEA discussion paper series 03039, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
  4. Mark V. Pauly, 2002. "Why the United States does Not Have Universal Health Insurance: A Public Finance and Public Choice Perspective," Public Finance Review, , vol. 30(5), pages 349-365, September.
  5. Friedrich Breyer & Andreas Haufler, 2000. "Health Care Reform: Separating Insurance from Income Redistribution," International Tax and Public Finance, Springer, vol. 7(4), pages 445-461, August.
  6. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  7. Pfarr, Christian, 2013. "Einkommen, Mobilität und individuelle Präferenzen für Umverteilung," Beiträge zur Finanzwissenschaft, Mohr Siebeck, Tübingen, edition 1, volume 30, number urn:isbn:9783161524714, July.
  8. Neil J. Buckley & Katherine Cuff & Jeremiah Hurley & Logan McLeod & Robert Nuscheler & David Cameron, 2012. "Willingness-to-pay for parallel private health insurance: evidence from a laboratory experiment," Canadian Journal of Economics, Canadian Economics Association, vol. 45(1), pages 137-166, February.
  9. Zweifel, Peter & Breuer, Michael, 2006. "Reply to our critics," Health Economics, Policy and Law, Cambridge University Press, vol. 1(02), pages 201-202, April.
  10. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
  11. Kifmann, Mathias & Roeder, Kerstin, 2011. "Premium subsidies and social insurance: Substitutes or complements?," hche Research Papers 2011/01, Hamburg Center for Health Economics (hche), University of Hamburg.
  12. Epple, Dennis & Romano, Richard E, 1996. "Public Provision of Private Goods," Journal of Political Economy, University of Chicago Press, vol. 104(1), pages 57-84, February.
  13. Janet Vroomen & Peter Zweifel, 2011. "Preferences for health insurance and health status: does it matter whether you are Dutch or German?," The European Journal of Health Economics, Springer, vol. 12(1), pages 87-95, February.
  14. Mickael Bech & Trine Kjaer & Jørgen Lauridsen, 2011. "Does the number of choice sets matter? Results from a web survey applying a discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 20(3), pages 273-286, March.
  15. Jan Kerssens & Peter Groenewegen, 2005. "Consumer preferences in social health insurance," The European Journal of Health Economics, Springer, vol. 6(1), pages 8-15, March.
  16. Peter Boxall & Wiktor Adamowicz, 2002. "Understanding Heterogeneous Preferences in Random Utility Models: A Latent Class Approach," Environmental & Resource Economics, European Association of Environmental and Resource Economists, vol. 23(4), pages 421-446, December.
  17. Hanemann, W. Michael, 1983. "Marginal welfare measures for discrete choice models," Economics Letters, Elsevier, vol. 13(2-3), pages 129-136.
  18. Johnson, F. Reed & Desvousges, William H., 1997. "Estimating Stated Preferences with Rated-Pair Data: Environmental, Health, and Employment Effects of Energy Programs," Journal of Environmental Economics and Management, Elsevier, vol. 34(1), pages 79-99, September.
  19. Zweifel, Peter & Breuer, Michael, 2006. "The case for risk-based premiums in public health insurance," Health Economics, Policy and Law, Cambridge University Press, vol. 1(02), pages 171-188, April.
  20. Chung-Ping Loh & Katrin Nihalani & Oliver Schnusenberg, 2012. "Measuring attitude toward social health insurance," The European Journal of Health Economics, Springer, vol. 13(6), pages 707-722, December.
  21. Mathias Kifmann, 2005. "Health insurance in a democracy: Why is it public and why are premiums income related?," Public Choice, Springer, vol. 124(3), pages 283-308, September.
  22. Pekelman, Dov & Sen, Subrata K, 1979. " Measurement and Estimation of Conjoint Utility Functions," Journal of Consumer Research, University of Chicago Press, vol. 5(4), pages 263-71, March.
  23. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74, pages 132.
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