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Public vs private demand for covering long term care expenditures

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  • R. Brau

    ()

  • M. Lippi Bruni
  • AM. Pinna

    ()

Abstract

This paper studies the determinants of the willingness to pay (WTP) for long term care (LTC) coverage provided through either a public or a private insurance program. Two insurance services are considered, a first one compulsory and financed out through general taxes, another one purchased on a voluntary base and paid through an insurance premium. Data are taken from a survey on a sample of households of the Italian region Emilia Romagna, and WTP is elicited through open-ended contingent valuation questions. We model individual choice as a two stage process, with respondents first establishing their interest for the service, then stating how much they are willing to pay. Auxiliary information allows us to separate zeros arising from standard corner solutions from those generated by disinterest. We test for independence of the interest" process by estimating Heckman's sample selection models both for the public and private case. We show that two sequential processes guide the observed WTP and that their separate identification is crucial for a clear understanding of individual choices. Interest and WTP are influenced by different variables, whereas the same variables influence the two choices in different ways. Moreover, we are able to investigate the differences in stated WTP between public and private provision. The kind of information provided is useful for designing reforms that more closely match collective preferences in a particularly delicate area such as elderly care financing.

Suggested Citation

  • R. Brau & M. Lippi Bruni & AM. Pinna, 2004. "Public vs private demand for covering long term care expenditures," Working Paper CRENoS 200408, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
  • Handle: RePEc:cns:cnscwp:200408
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    References listed on IDEAS

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    Cited by:

    1. Matteo Lippi Bruni & Cristina Ugolini, 2016. "Delegating home care for the elderly to external caregivers? An empirical study on Italian data," Review of Economics of the Household, Springer, vol. 14(1), pages 155-183, March.
    2. Rinaldo Brau & Matteo Lippi Bruni, 2008. "Eliciting the demand for long-term care coverage: a discrete choice modelling analysis," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 411-433.
    3. G. Marletto, 2006. "La politica dei trasporti come politica per l'innovazione: spunti da un approccio evolutivo," Working Paper CRENoS 200605, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
    4. OA Carboni & G. Medda, 2007. "Government Size and the Composition of Public Spending in a Neoclassical Growth Model," Working Paper CRENoS 200701, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.

    More about this item

    Keywords

    health insurance; long term care; willingness to pay; hurdle models;

    JEL classification:

    • C34 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Truncated and Censored Models; Switching Regression Models
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H40 - Public Economics - - Publicly Provided Goods - - - General

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