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Supplemental health insurance and equality of access in Belgium

  • Erik Schokkaert
  • Tom Van Ourti
  • Diana De Graeve

    (Faculty of Applied Economics, University of Antwerp, Antwerp, Belgium)

  • Ann Lecluyse

    (Faculty of Applied Economics, University of Antwerp, Antwerp, Belgium)

  • Carine Van de Voorde

    (Belgian Health Care Knowledge Centre, Brussels, Belgium)

The effects of supplemental health insurance on health-care consumption crucially depend on specific institutional features of the health-care system. We analyse the situation in Belgium, a country with a very broad coverage in compulsory social health insurance and where supplemental insurance mainly refers to extra-billing in hospitals. Within this institutional background, we find only weak evidence of adverse selection in the coverage of supplemental health insurance. We find much stronger effects of socio-economic background. We estimate a bivariate probit model and cannot reject the assumption of exogeneity of insurance availability for the explanation of health-care use. A count model for hospital care shows that supplemental insurance has no significant effect on the number of spells, but a negative effect on the number of nights per spell. We comment on the implications of our findings for equality of access to health care in Belgium. Copyright © 2009 John Wiley & Sons, Ltd.

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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 19 (2010)
Issue (Month): 4 ()
Pages: 377-395

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Handle: RePEc:wly:hlthec:v:19:y:2010:i:4:p:377-395
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