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Preference for National Health Service Use and the Demand for Private Health Insurance in Spain


  • Joan Costa-Font

    (LSE Health and Social Care, London School of Economics, London U.K. and Universitat de Barcelona, Barcelona, Spain.)

  • Montserrat Font-Vilalta

    (Universitat de Barcelona, Barcelona, Spain)


In National Health Systems (“NHS”) the funding and provision of health care co-exists with a developing market for private (supplementary) health insurance. In this setting, interactions between the public and private sector are important and likely to influence the demand for private health insurance (“PHI”). This paper empirically examines the interactions between PHI and NHS use using a representative survey for Catalonia (Spain). Our findings show that PHI stands as a financial tool for accessing private health care in Spain. Use of NHS care and the demand for private health insurance are simultaneously determined. The individual take-up of PHI results from a lower use of primary and specialized NHS care. Furthermore, preferences for the NHS care are influenced by captivity towards the NHS care. The Geneva Papers on Risk and Insurance (2004) 29, 705–718. doi:10.1111/j.1468-0440.2004.00312.x

Suggested Citation

  • Joan Costa-Font & Montserrat Font-Vilalta, 2004. "Preference for National Health Service Use and the Demand for Private Health Insurance in Spain," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 705-718, October.
  • Handle: RePEc:pal:gpprii:v:29:y:2004:i:4:p:705-718

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    References listed on IDEAS

    1. Friedrich Breyer & Andreas Haufler, 2000. "Health Care Reform: Separating Insurance from Income Redistribution," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 7(4), pages 445-461, August.
    2. Florian Baumann & Volker Meier & Martin Werding, 2008. "Transferable Ageing Provisions in Individual Health Insurance Contracts," German Economic Review, Verein für Socialpolitik, vol. 9, pages 287-311, August.
    3. Kifmann, Mathias, 2002. "Insuring Premium Risk in Competitive Health Insurance Markets," Beiträge zur Finanzwissenschaft, Mohr Siebeck, Tübingen, edition 1, volume 15, number urn:isbn:9783161477409.
    4. Homburg, Stefan, 2000. "Compulsory savings in the welfare state," Journal of Public Economics, Elsevier, vol. 77(2), pages 233-239, August.
    5. Breyer, Friedrich & Franz, Wolfgang & Homburg, Stefan & Schnabel, Reinhold & Wille, Eberhard, 2004. "Reform der sozialen Sicherung," EconStor Books, ZBW - German National Library of Economics, number 92399.
    6. Cochrane, John H, 1995. "Time-Consistent Health Insurance," Journal of Political Economy, University of Chicago Press, vol. 103(3), pages 445-473, June.
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    Cited by:

    1. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2010. "Waiting times and the decision to buy private health insurance. CHERE Working Paper 2010/9," Working Papers 2010/9, CHERE, University of Technology, Sydney.
    2. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2010. "The demand for private health insurance: do waiting lists or waiting times matter? CHERE Working Paper 2010/8," Working Papers 2010/8, CHERE, University of Technology, Sydney.
    3. Randall Ellis & Elizabeth Savage, 2008. "Run for cover now or later? The impact of premiums, threats and deadlines on private health insurance in Australia," International Journal of Health Economics and Management, Springer, vol. 8(4), pages 257-277, December.
    4. Stephanie Knox & Elizabeth Savage & Denzil Fiebig & Vineta Salale, 2010. "Joiners and leavers stayers and abstainers: Private health insurance choices in Australia," Working Papers 2010/4, CHERE, University of Technology, Sydney.

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