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Who opts out of the statutory health insurance? A discrete time hazard model for Germany

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  • Bünnings, Christian
  • Tauchmann, Harald

Abstract

The coexistence of social health insurance and private health insurance in Germany is subject to intense public debate. As only few have the opportunity to choose between the two systems, they are often regarded as privileged by the health insurance system. Applying a hazard model in discrete time, this paper examines the role of incentives set by the regulatory framework as well as the influence of individual personality characteristics on the decision to opt out of the statutory system. To address potential endogeneity of one of the key explanatory variables an instrumental variable approach is also applied. The estimation results yield robust evidence on the choice of health insurance type that is consistent with rational decision making, with both incentives set by regulation and personality traits as relevant determinants. --

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Paper provided by Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Wirtschaftspolitik und Quantitative Wirtschaftsforschung (IWQW) in its series IWQW Discussion Paper Series with number 10/2013.

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Date of creation: 2013
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Handle: RePEc:zbw:iwqwdp:102013

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Web page: http://www.iwqw.rw.uni-erlangen.de/
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Keywords: statutory and private health insurance; incentives; personality traits;

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  1. Hullegie, Patrick & Klein, Tobias J., 2010. "The Effect of Private Health Insurance on Medical Care Utilization and Self-Assessed Health in Germany," IZA Discussion Papers 5004, Institute for the Study of Labor (IZA).
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  8. Martina Grunow & Robert Nuscheler, 2010. "Public and Private Health Insurance in Germany: The Ignored Risk Selection Problem," Working Papers 093, Bavarian Graduate Program in Economics (BGPE).
  9. Anne-Fleur Roos & Frederik Schut, 2012. "Spillover effects of supplementary on basic health insurance: evidence from the Netherlands," The European Journal of Health Economics, Springer, vol. 13(1), pages 51-62, February.
  10. Walendzik, Anke & Greß, Stefan & Manouguian, Maral & Wasem, Jürgen, 2008. "Vergütungsunterschiede im ärztlichen Bereich zwischen PKV und GKV auf Basis des standardisierten Leistungsniveaus der GKV und Modelle der Vergütungsangleichung," IBES Diskussionsbeiträge 165, University of Duisburg-Essen, Faculty for Economics and Business Administration.
  11. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334.
  12. Hendrik Jürges, 2009. "Health Insurance Status and Physician Behavior in Germany," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 129(2), pages 297-307.
  13. John P. Haisken-DeNew & Markus H. Hahn, 2010. "PanelWhiz: Efficient Data Extraction of Complex Panel Data Sets - An Example Using the German SOEP," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 130(4), pages 643-654.
  14. Robert Nuscheler & Thomas Knaus, 2005. "Risk selection in the German public health insurance system," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1253-1271.
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