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

Assurance maladie en Suisse : les assurances supplémentaires nuisent-elles à la concurrence sur l'assurance de base ?

  • Dormont, Brigitte
  • Geoffard, Pierre-Yves
  • Lamiraud, Karine

De nombreux pays ont introduit des mécanismes concurrentiels en assurance maladie, tout en instaurant une régulation pour éviter la sélection des risques et garantir une solidarité entre malades et bien portants. Le modèle de la « concurrence régulée » est ainsi appliqué pour l'assurance maladie de base en Suisse, aux Pays-Bas, en Allemagne, en Israël. Il inspire la réforme de l'assurance maladie aux États-Unis. Cet article analyse le fonctionnement d'un tel système en considérant le cas de la Suisse, où l'on s'intéresse aux interférences potentielles entre le marché des assurances supplémentaires et celui de l'assurance de base. L'organisation actuelle de l'assurance maladie en France diffère de celle du système suisse. Mais la question d'une régulation du marché des assurances complémentaires pourrait être posée à terme. Douze ans après l'introduction de la concurrence régulée, les résultats observés en Suisse sont décevants. Bien que les écarts de primes constatés entre les compagnies d'assurance soient très importants, la proportion d'assurés qui changent de caisse reste faible. Tout se passe comme si les assurés ne faisaient pas jouer la concurrence. Notre analyse montre que la faible mobilité des assurés résulte de la coexistence de deux marchés d'assurance maladie soumis à des règles différentes : le marché de l'assurance de base, où la sélection des risques est interdite, et celui de l'assurance supplémentaire, où elle est autorisée. Les estimations montrent que la propension à changer de caisse est beaucoup plus faible chez les détenteurs d'une assurance supplémentaire qui estiment que leur santé n'est pas excellente. Comme il est préférable pour des raisons pratiques d'avoir son assurance de base et son assurance supplémentaire dans la même caisse, il existe un lien de fait entre les deux marchés. Le droit de sélectionner les candidats à la souscription pour l'assurance supplémentaire nuit à la concurrence sur l'assurance de base.

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://basepub.dauphine.fr/xmlui/bitstream/123456789/11294/1/ES455E.pdf
Download Restriction: no

Paper provided by Paris Dauphine University in its series Economics Papers from University Paris Dauphine with number 123456789/11294.

as
in new window

Length:
Date of creation: May 2013
Date of revision:
Publication status: Published in Economie et statistique, 2013, no. 455-456. pp. 71-87.Length: 16 pages
Handle: RePEc:dau:papers:123456789/11294
Contact details of provider: Web page: http://www.dauphine.fr/en/welcome.html

More information through EDIRC

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Marcus Tamm & Harald Tauchmann & Jürgen Wasem & Stefan Gre�, 2007. "Elasticities of market shares and social health insurance choice in germany: a dynamic panel data approach," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 243-256.
  2. Beaulieu, Nancy Dean, 2002. "Quality information and consumer health plan choices," Journal of Health Economics, Elsevier, vol. 21(1), pages 43-63, January.
  3. Buchmueller, Thomas C. & Feldstein, Paul J., 1997. "The effect of price on switching among health plans," Journal of Health Economics, Elsevier, vol. 16(2), pages 231-247, April.
  4. Robert Nuscheler & Thomas Knaus, 2005. "Risk selection in the German public health insurance system," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1253-1271.
  5. Ian M. McCarthy & Rusty Tchernis, 2010. "Search costs and Medicare plan choice," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1142-1165.
  6. Tversky, Amos & Kahneman, Daniel, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, MIT Press, vol. 106(4), pages 1039-61, November.
  7. Douglas Staiger & James H. Stock, 1994. "Instrumental Variables Regression with Weak Instruments," NBER Technical Working Papers 0151, National Bureau of Economic Research, Inc.
  8. Strombom, Bruce A. & Buchmueller, Thomas C. & Feldstein, Paul J., 2002. "Switching costs, price sensitivity and health plan choice," Journal of Health Economics, Elsevier, vol. 21(1), pages 89-116, January.
  9. Abraham, Jean M. & Feldman, Roger & Carlin, Caroline & Christianson, Jon, 2006. "The effect of quality information on consumer health plan switching: Evidence from the Buyers Health Care Action Group," Journal of Health Economics, Elsevier, vol. 25(4), pages 762-781, July.
  10. Anne-Fleur Roos & Frederik Schut, 2012. "Spillover effects of supplementary on basic health insurance: evidence from the Netherlands," The European Journal of Health Economics, Springer, vol. 13(1), pages 51-62, February.
  11. 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.
  12. Samuelson, William & Zeckhauser, Richard, 1988. " Status Quo Bias in Decision Making," Journal of Risk and Uncertainty, Springer, vol. 1(1), pages 7-59, March.
  13. Richard Frank & Karine Lamiraud, 2008. "Choice, Price Competition and Complexity in Markets for Health Insurance," NBER Working Papers 13817, National Bureau of Economic Research, Inc.
  14. Francesca Colombo & Nicole Tapay, 2004. "Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Papers 15, OECD Publishing.
  15. Anne Beeson Royalty & Neil Solomon, 1999. "Health Plan Choice: Price Elasticities in a Managed Competition Setting," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 1-41.
Full references (including those not matched with items on IDEAS)

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:dau:papers:123456789/11294. 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: (Alexandre Faure)

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.