IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this article or follow this journal

Consumer Mobility in Social Health Insurance Markets: A Five-Country Comparison

  • Trea Laske-Aldershof

    (Institute of Health Policy and Management, Erasmus University Medical Centre, Rotterdam, The Netherlands)

  • Erik Schut

    (Institute of Health Policy and Management, Erasmus University Medical Centre, Rotterdam, The Netherlands)

  • Konstantin Beck

    (Department of Statistics, CSS Insurance, Lucerne, Switzerland)

  • Stefan Gress

    (Institute for Health Care Management, University of Duisberg-Essen, Essen, Germany)

  • Amir Shmueli

    (Department of Health Management, School of Public Health, The Hebrew University, Jerusalem, Israel)

  • Carine Van de Voorde

    (Centre for Economic Studies, Katholieke Universiteit Leuven, Leuven, Belgium)

Registered author(s):

    During the 1990s, the social health insurance schemes of Germany, the Netherlands, Switzerland, Belgium and Israel were significantly reformed by the introduction of freedom of choice (open enrolment) of health insurer. This was introduced alongside a system of risk adjustment to compensate health insurers for enrolees with predictable high medical expenses. Despite the similarity in the health insurance reforms in these countries, we find that both the rationale behind these reforms and their impact on consumer choice vary widely. In this article we seek to explain the observed variation in switching rates by cross-country comparison of the potential determinants of health insurer choice. We conclude that differences in choice setting, and in the net benefits of switching, offer a plausible explanation for the large differences in consumer mobility. Finally, we discuss the policy implications of our cross-country comparison. We argue that the optimal switching rate crucially depends on the goals of the reforms and the quality of the risk-adjustment system. In view of this, we conclude that switching rates are currently too low in the Netherlands, and an active government policy to encourage consumer mobility seems warranted. In Germany and Switzerland, high switching rates call for an improvement of the rather poor risk-adjustment systems. Given low switching rates in Israel and Belgium, improving risk adjustment is less urgent, but still required in the long run.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL: http://healtheconomics.adisonline.com/pt/re/ahe/pdfhandler.00148365-200403040-00006.pdf
    Download Restriction: Pay per view

    File URL: http://healtheconomics.adisonline.com/pt/re/ahe/fulltext.00148365-200403040-00006.htm
    Download Restriction: Pay per view

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Article provided by Springer Healthcare | Adis in its journal Applied Health Economics and Health Policy.

    Volume (Year): 3 (2004)
    Issue (Month): 4 ()
    Pages: 229-241

    as
    in new window

    Handle: RePEc:wkh:aheahp:v:3:y:2004:i:4:p:229-241
    Contact details of provider: Web page: http://healtheconomics.adisonline.com/

    No references listed on IDEAS
    You can help add them by filling out this form.

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:wkh:aheahp:v:3:y:2004:i:4:p:229-241. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin)

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.