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Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal

Author

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  • Aida Isabel Tavares

    (ISEG, Lisbon School of Economics and Management
    CEISUC, Centre of Studies and Research in Health of the University of Coimbra)

  • Inês Marques

    (CEISUC, Centre of Studies and Research in Health of the University of Coimbra)

Abstract

The Portuguese health system has the peculiar characteristic of being a Beveridge–Bismarck type aiming at universal coverage. On top of the national health system coverage, there is a second coverage provided to some professionals, plus a third layer of coverage that can be acquired by taking out voluntary private health insurance. The aim of this work is to ascertain whether people benefiting from supplemental multi-layer health coverage (on top of the existing National Health System) have more consultations, either with general practitioners or with specialists, and enjoy better health status. We used data from the National Health Survey from 2014 to estimate a recursive system of ordered probits. The main results confirm that multi-layer health coverage is correlated with the use of more specialist consultations, but not with more GP consultations. It is also correlated with better health status. These results may indicate the existence of moral hazard, induced demand and/or 'access effect'. Regarding policy matters, the measures aimed to reduce waiting times, improve patient choice, and increase access could counteract such results and mitigate the potential inequity of access and health status, and also excessive use of medical services that can happen under double health coverage.

Suggested Citation

  • Aida Isabel Tavares & Inês Marques, 2021. "Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 141-153, February.
  • Handle: RePEc:spr:eujhec:v:22:y:2021:i:1:d:10.1007_s10198-020-01242-4
    DOI: 10.1007/s10198-020-01242-4
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    References listed on IDEAS

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 8th February 2021
      by Rita Faria in The Academic Health Economists' Blog on 2021-02-08 12:00:01

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    More about this item

    Keywords

    Health insurance; Coverage; Utilization; Health;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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