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The effect of private health insurance on medical care utilization and self-assessed health in Germany

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  • Hullegie P
  • Klein TJ

Abstract

In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductables are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance threshold. Here, premia are based on age and health, individuals may choose to what extent they are covered, and deductables and co-payments are common. In this paper we estimate the effect of private insurance coverage on the number of doctor visits and self-assessed health. Variation in income around the compulsory insurance threshold provides a natural experiment that we exploit to control for selection into private insurance. We document that income is measured with error and suggest an approach to take this into account. We find negative effects of private insurance coverage on the number of doctor visits and positive effects on health.

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Bibliographic Info

Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 09/17.

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Date of creation: Jul 2009
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Handle: RePEc:yor:hectdg:09/17

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Web page: http://www.york.ac.uk/economics/postgrad/herc/hedg/
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Keywords: Private health insurance; medical care utilization; selection into insurance; natural experiment; regression discontinuity design; measurement error.;

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References

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Cited by:
  1. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2014. "The Effects of Access to Health Insurance for Informally Employed Individuals in Peru," IZA Discussion Papers 8213, Institute for the Study of Labor (IZA).
  2. Wittwer, Jérôme & Guthmuller, Sophie, 2012. "Means-tested complementary health insurance and healthcare utilisation in France: Evidence from a low-income population," Economics Papers from University Paris Dauphine 123456789/9533, Paris Dauphine University.
  3. Anikó Bíró, 2014. "Supplementary private health insurance and health care utilization of people aged 50+," Empirical Economics, Springer, vol. 46(2), pages 501-524, March.
  4. Bonsang Eric & Klein Tobias J., 2011. "Retirement and Subjective Well-Being," ROA Research Memorandum 005, Maastricht University, Research Centre for Education and the Labour Market (ROA).
  5. Bünnings, Christian & Tauchmann, Harald, 2013. "Who opts out of the statutory health insurance? A discrete time hazard model for Germany," IWQW Discussion Paper Series 10/2013, Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Wirtschaftspolitik und Quantitative Wirtschaftsforschung (IWQW).
  6. Denise Doiron & Denzil G Fiebig & Agne Suziedelyte, 2013. "Hips and hearts: the variation in incentive effects of insurance across hospital procedures," Discussion Papers 2013-14, School of Economics, The University of New South Wales.

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