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Supplemental health insurance and equality of access in Belgium

Author

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  • SCHOKKAERT, Erik
  • VAN OURTI, Tom
  • DE GRAEVE, Diana
  • LECLUYSE, Ann

Abstract

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.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • SCHOKKAERT, Erik & VAN OURTI, Tom & DE GRAEVE, Diana & LECLUYSE, Ann, 2010. "Supplemental health insurance and equality of access in Belgium," LIDAM Reprints CORE 2197, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    • Handle: RePEc:cor:louvrp:2197
    DOI: 10.1002/hec.1478
    Note: In : Health Economics, 19(4), 377-395, 2010
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    Cited by:

    1. Izabela Jelovac, 2015. "Physicians’ balance billing, supplemental insurance and access to health care," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 269-280, June.
    2. Astrid Kiil, 2012. "Does employment-based private health insurance increase the use of covered health care services? A matching estimator approach," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 1-38, March.
    3. Nikos Nomikos & Panagiota Naoum & Vasiliki Naoum & Kostas Athanasakis & John Kyriopoulos & Elpida Pavi, 2022. "Individuals' personal characteristics associated with private health insurance policy possession in Greece," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 361-371, January.
    4. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    5. Carine Franc & Marc Perronnin & Aurélie Pierre, 2016. "Supplemental Health Insurance and Healthcare Consumption—A Dynamic Approach to Moral Hazard," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1582-1598, December.
    6. Renate Lange & Jörg Schiller & Petra Steinorth, 2015. "Demand and Selection Effects in Supplemental Health Insurance in Germany," SOEPpapers on Multidisciplinary Panel Data Research 757, DIW Berlin, The German Socio-Economic Panel (SOEP).
    7. Léa Toulemon, 2016. "Job quality, Health Insurance and the Price of Medical Products: Essays in Applied Economics," Sciences Po publications info:hdl:2441/3018m4nhj18, Sciences Po.
    8. Coleman Drake & Mark K. Meiselbach & Daniel Polsky, 2025. "Efficient Subsidy Targeting in the Health Insurance Marketplaces," Papers 2510.13791, arXiv.org, revised Oct 2025.
    9. Renate Lange & Jörg Schiller & Petra Steinorth, 2017. "Demand and Selection Effects in Supplemental Health Insurance in Germany," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(1), pages 5-30, January.
    10. Lecluyse, Ann & Van de Voorde, Carine & De Graeve, Diana & Schokkaert, Erik & Van Ourti, Tom, 2009. "Hospital supplements in Belgium: Price variation and regulation," Health Policy, Elsevier, vol. 92(2-3), pages 276-287, October.
    11. Shahla Akram & Zahid Pervaiz, 2025. "Assessing Inequality of Opportunities for Child Well-being in Pakistan," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 18(2), pages 525-542, April.
    12. Léa Toulemon, 2016. "Job quality, health insurance and the price of medical products : essays in applied economics [Qualité de l'emploi, assurance santé et prix des médicaments à l'hôpital : essais en économie appliqué," Sciences Po Economics Publications (main) tel-03455279, HAL.
    13. Carine Franc & Marc Perronnin & Aurelie Pierre, 2014. "Supplemental Health Insurance and Healthcare Consumption: A Dynamic Approach to Moral Hazard," Working Papers DT58, IRDES institut for research and information in health economics, revised Jan 2014.
    14. Ko, Hansoo, 2020. "Moral hazard effects of supplemental private health insurance in Korea," Social Science & Medicine, Elsevier, vol. 265(C).
    15. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    16. Chaohsin Lin & Shuofen Hsu, 2025. "The effects of selection and moral hazard in additional health insurance in a universal healthcare system: evidence from Taiwan," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 50(2), pages 444-466, April.
    17. Astrid Kiil & Jacob Nielsen Arendt, 2017. "The effect of complementary private health insurance on the use of health care services," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 1-27, March.
    18. Raf Van Gastel & Tim Goedemé & Julie Janssens & Eva Lefevere & Rik Lemkens, 2017. "A Reminder to Pay Less for Healthcare: take-up of Increased Reimbursement in a large-scale randomized field experiment," Working Papers 1712, Herman Deleeck Centre for Social Policy, University of Antwerp.
    19. Perronnin, Marc, 2013. "Effet de l'assurance complémentaire santé sur les consommations médicales, entre risque moral et amélioration de l'accès aux soins," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13659 edited by Wittwer, Jérôme.
    20. Hiroki Wakamatsu & Seiichi Fukui & Kana Miwa, 2019. "Heterogeneous Preferences for Micro Health Insurance Attributes in Rural Cambodia: Latent Class Analysis," Economics Bulletin, AccessEcon, vol. 39(4), pages 2963-2975.
    21. Sofia Vaz & Pedro Ramos, 2016. "Where did civil servants go? the effect of an increase in public co-payments on double insured patients," Health Economics Review, Springer, vol. 6(1), pages 1-8, December.
    22. Buchmueller, Thomas C. & Fiebig, Denzil G. & Jones, Glenn & Savage, Elizabeth, 2013. "Preference heterogeneity and selection in private health insurance: The case of Australia," Journal of Health Economics, Elsevier, vol. 32(5), pages 757-767.
    23. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).

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