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A Physician Fee that Applies to Acute but not to Preventive Care: Evidence from a German Deductible Program

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  • Stefan Felder
  • Andreas Werblow

Abstract

A certain German sickness fund offers €240 per year to its clients if they pay the first €300 of their health care bills, except for physician visits, for which a flat rate of €20 applies. This paper studies the effects of this deductible scheme on health care demand by comparing about 5,000 participants with a control sample, using the sickness fund’s claims data covering in-patient care, prescription drugs, and ambulatory care. The data extend to three years: the year of the start of the program and the two years preceding this. We apply a parametric approach that models the choice of the deductible program, the probability of positive expenses as well as the demand for health care services, conditional on demand being positive. Instruments for the participation decision are used, and the results are compared with those of an exogenous specification of the program choice. The physician fee appears to significantly decrease the number of visits as well as the expenses for curative care. By contrast, prevention activities, not subject to the co-payment, remain constant.

Suggested Citation

  • Stefan Felder & Andreas Werblow, 2008. "A Physician Fee that Applies to Acute but not to Preventive Care: Evidence from a German Deductible Program," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 128(2), pages 191-212.
    • Handle: RePEc:aeq:aeqsjb:v128_y2008_i2_q2_p191-212
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    Citations

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    Cited by:

    1. Hendrik Schmitz, 2012. "More health care utilization with more insurance coverage? Evidence from a latent class model with German data," Applied Economics, Taylor & Francis Journals, vol. 44(34), pages 4455-4468, December.
    2. Stefanie Thönnes, 2019. "Ex-post moral hazard in the health insurance market: empirical evidence from German data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1317-1333, December.
    3. Miriam Krieger & Stefan Felder, 2013. "Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice," IJERPH, MDPI, vol. 10(6), pages 1-18, June.
    4. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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