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Selection on moral hazard in the Swiss market for mandatory health insurance: Empirical evidence from Swiss Household Panel data

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  • Francetic Igor

Abstract

Selection on moral hazard represents the tendency to select a specific health insurance coverage depending on the heterogeneity in utilisation ''slopes''. I use data from the Swiss Household Panel and from publicly available regulatory data to explore the extent of selection on slopes in the Swiss managed competition system. I estimate responses in terms of (log) doctor visits to lowest and highest deductible levels using Roy-type models, identifying marginal treatment effects with local instrumental variables. The response to high coverage plans (i.e. plans with the lowest deductible level) among high moral hazard types is 25-35 percent higher than average.

Suggested Citation

  • Francetic Igor, 2022. "Selection on moral hazard in the Swiss market for mandatory health insurance: Empirical evidence from Swiss Household Panel data," Papers 2208.03815, arXiv.org, revised Sep 2023.
  • Handle: RePEc:arx:papers:2208.03815
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    References listed on IDEAS

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    1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456, July.
    2. James J. Heckman & Sergio Urzua & Edward Vytlacil, 2006. "Understanding Instrumental Variables in Models with Essential Heterogeneity," The Review of Economics and Statistics, MIT Press, vol. 88(3), pages 389-432, August.
    3. Stefan Boes & Michael Gerfin, 2016. "Does Full Insurance Increase the Demand for Health Care?," Health Economics, John Wiley & Sons, Ltd., vol. 25(11), pages 1483-1496, November.
    4. Brigitte Dormont & Pierre‐Yves Geoffard & Karine Lamiraud, 2009. "The influence of supplementary health insurance on switching behaviour: evidence from Swiss data," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1339-1356, November.
    5. Pedro Carneiro & James J. Heckman & Edward J. Vytlacil, 2011. "Estimating Marginal Returns to Education," American Economic Review, American Economic Association, vol. 101(6), pages 2754-2781, October.
    6. Liran Einav & Amy Finkelstein, 2018. "Moral Hazard in Health Insurance: What We Know and How We Know It," Journal of the European Economic Association, European Economic Association, vol. 16(4), pages 957-982.
    7. Christine Sevilla-Dedieu & Nathalie Billaudeau & Alain Paraponaris, 2020. "Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment," Health Economics Review, Springer, vol. 10(1), pages 1-10, December.
    8. Kaufmann, Cornel & Schmid, Christian & Boes, Stefan, 2017. "Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes," Journal of Health Economics, Elsevier, vol. 55(C), pages 262-273.
    9. Pierre-Andre Chiappori & Bernard Salanie, 2000. "Testing for Asymmetric Information in Insurance Markets," Journal of Political Economy, University of Chicago Press, vol. 108(1), pages 56-78, February.
    10. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    11. Marika Cabral, 2017. "Claim Timing and Ex Post Adverse Selection," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 84(1), pages 1-44.
    12. repec:dau:papers:123456789/1623 is not listed on IDEAS
    13. David M. Cutler & Sarah J. Reber, 1998. "Paying for Health Insurance: The Trade-Off between Competition and Adverse Selection," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 113(2), pages 433-466.
    14. Edward Vytlacil & James J. Heckman, 2001. "Policy-Relevant Treatment Effects," American Economic Review, American Economic Association, vol. 91(2), pages 107-111, May.
    15. Rob J. M. Alessie & Viola Angelini & Jochen O. Mierau & Laura Viluma, 2020. "Moral hazard and selection for voluntary deductibles," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1251-1269, October.
    16. Miriam Krieger & Stefan Felder, 2013. "Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice," IJERPH, MDPI, vol. 10(6), pages 1-18, June.
    17. Michael Gerfin & Martin Schellhorn, 2006. "Nonparametric bounds on the effect of deductibles in health care insurance on doctor visits – Swiss evidence," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 1011-1020, September.
    18. Karolin Becker & Peter Zweifel, 2005. "Cost Sharing in Health Insurance: An Instrument for Risk Selection?," SOI - Working Papers 0513, Socioeconomic Institute - University of Zurich.
    19. Pau Olivella & Marcos Vera‐Hernández, 2013. "Testing for Asymmetric Information in Private Health Insurance-super-," Economic Journal, Royal Economic Society, vol. 123(567), pages 96-130, March.
    20. Scott Brave & Thomas Walstrum, 2014. "Estimating marginal treatment effects using parametric and semiparametric methods," Stata Journal, StataCorp LP, vol. 14(1), pages 191-217, March.
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    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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