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Public health insurance, individual health, and entry into self-employment

Author

Listed:
  • Frank M. Fossen

    (University of Nevada, Reno
    DIW
    IZA)

  • Johannes König

    (Freie Universität Berlin)

Abstract

We investigate the impact of a differential treatment of paid employees versus self-employed workers in a public health insurance system on the entry rate into self-employment. Health insurance systems that distinguish between the two sectors of employment create incentives or disincentives to start a business for different individuals. We estimate a discrete time hazard rate model of entry into self-employment based on representative household panel data for Germany, which include individual health information. The results indicate that an increase in the health insurance cost differential between self-employed workers and paid employees by €10 per month decreases the probability of entry into self-employment by 1.7% of the annual entry rate. This shows that entrepreneurship lock, which an emerging literature describes for the system of employer-provided health insurance in the USA, can also occur in a public health insurance system. Therefore, entrepreneurial activity should be taken into account when discussing potential health-care reforms.

Suggested Citation

  • Frank M. Fossen & Johannes König, 2017. "Public health insurance, individual health, and entry into self-employment," Small Business Economics, Springer, vol. 49(3), pages 647-669, October.
  • Handle: RePEc:kap:sbusec:v:49:y:2017:i:3:d:10.1007_s11187-017-9843-0
    DOI: 10.1007/s11187-017-9843-0
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    Cited by:

    1. Jun Yeong Lee & John V. Winters, 2022. "State Medicaid Expansion and the Self-Employed," Small Business Economics, Springer, vol. 59(3), pages 925-954, October.
    2. Le, Nga & Groot, Wim & Tomini, Sonila M. & Tomini, Florian, 2019. "Health insurance and self-employment transitions in Vietnam," MERIT Working Papers 2019-008, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    3. Kwapisz, Agnieszka, 2020. "Health insurance coverage and sources of advice in entrepreneurship: Gender differences," Journal of Business Venturing Insights, Elsevier, vol. 14(C).
    4. Fossen, Frank M. & Hossain, Mobarak & Mukhopadhyay, Sankar & Toth, Peter, 2021. "The Cost of Health Insurance and Entry into Entrepreneurship," IZA Discussion Papers 14891, Institute of Labor Economics (IZA).
    5. David B. Audretsch & Maksim Belitski & Farzana Chowdhury & Sameeksha Desai, 2022. "Necessity or opportunity? Government size, tax policy, corruption, and implications for entrepreneurship," Small Business Economics, Springer, vol. 58(4), pages 2025-2042, April.
    6. Le, Nga & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2018. "Health insurance and self-employment transitions in Vietnam: A multinomial analysis," MERIT Working Papers 2018-039, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    7. Panka Bencsik & Tuugi Chuluun, 2021. "Comparative well-being of the self-employed and paid employees in the USA," Small Business Economics, Springer, vol. 56(1), pages 355-384, January.

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    More about this item

    Keywords

    Health insurance; Health; Entrepreneurship lock; Self-employment;
    All these keywords.

    JEL classification:

    • L26 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Entrepreneurship
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J2 - Labor and Demographic Economics - - Demand and Supply of Labor

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