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Choosing Health Insurance in a Dual Health Care System: The Chilean Case

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  • Ricardo Sanhueza
  • Jaime Ruiz-Tagle

Abstract

In Chile there is a public insurance system where people contribute a fixed percentage of their income, and also a private system where people pay a premium based on their personal characteristics. Using a large survey for 1996, we study the determinants of the decision to buy a private health plan. We find that the probability of buying a private health plan is positively correlated with income and living in areas with private health services providers. This probability decreases as families become older, and with a larger proportion of fertile age females. We also find that people who are more likely to demand health services prefer to buy a private health plan, and that people enrolled in a private health plan increase their use of health services. The segmentation observed in the health sector relates with the way private insurers and the public insurance system set their premiums.

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  • Ricardo Sanhueza & Jaime Ruiz-Tagle, 2002. "Choosing Health Insurance in a Dual Health Care System: The Chilean Case," Journal of Applied Economics, Taylor & Francis Journals, vol. 5(1), pages 157-184, May.
    • Handle: RePEc:taf:recsxx:v:5:y:2002:i:1:p:157-184
    DOI: 10.1080/15140326.2002.12040574
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    1. Hubert Amu & Kwamena Sekyi Dickson & Akwasi Kumi-Kyereme & Eugene Kofuor Maafo Darteh, 2018. "Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-14, August.
    2. Duarte, Fabian, 2012. "Price elasticity of expenditure across health care services," Journal of Health Economics, Elsevier, vol. 31(6), pages 824-841.
    3. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    4. Pardo, Cristian, 2019. "Health care reform, adverse selection and health insurance choice," Journal of Health Economics, Elsevier, vol. 67(C).
    5. Bitrán, Eduardo & Duarte, Fabián & Fernandes, Dalila & Villena, Marcelo, 2017. "Impact of the Guaranteed Health Plan with a single community premium on the demand for private health insurance in Chile," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), December.
    6. Bronfman, Javier, 2014. "Universal health insurance under a dual system, evidence of adverse selection against the public sector: the case of Chile," MPRA Paper 63262, University Library of Munich, Germany.
    7. Rotarou, Elena S. & Sakellariou, Dikaios, 2017. "Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile," Health Policy, Elsevier, vol. 121(5), pages 495-503.
    8. Bronfman, Javier, 2011. "Health Insurance Choice, Moral Hazard and Adverse Selection: A Study of the Chilean Case Using Panel Data," MPRA Paper 63266, University Library of Munich, Germany.
    9. Cristian Pardo & Whitney Schott, 2012. "Public versus private: evidence on health insurance selection," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 39-61, March.
    10. Ricardo Henriquez Hofter, 2006. "Private health insurance and utilization of health services in Chile," Applied Economics, Taylor & Francis Journals, vol. 38(4), pages 423-439.

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    More about this item

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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