IDEAS home Printed from https://ideas.repec.org/p/hal/psewpa/hal-00795544.html
   My bibliography  Save this paper

Assurance maladie en Suisse : l'assurance supplémentaire nuit-elle à la concurrence sur l'assurance de base ?

Author

Listed:
  • Brigitte Dormont

    (Laboratoire d'économie et de gestion des organisations de santé - Université Paris-Dauphine)

  • Pierre-Yves Geoffard

    (PSE - Paris-Jourdan Sciences Economiques - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique, PSE - Paris School of Economics)

  • Karine Lamiraud

    (Economics Department - Essec Business School)

Abstract

Many countries have introduced competition in health insurance markets. Managed competition settings have been implemented in order to avoid risk selection problems. In Germany, the Netherlands, Switzerland and Israel citizens can choose between different providers for basic coverage. In this article, we focus on the specific case of Switzerland which implemented managed competition in basic health insurance markets in 1996. We study to what extent consumer choice for one's basic health plan may interact with the decision to subscribe to supplementary insurance. The organization of social health insurance in France is currently very different from the Swiss system. However the question of regulating complementary health care insurance markets in France may be discussed in the middle/long run using the Swiss model. In Switzerland, competition in basic health insurance markets has not been effective so far. There is no evidence of premium convergence within cantons. Consumers have been reluctant to switch to less expensive funds. We investigate one possible barrier to switching behavior, namely the influence of supplementary insurance. We show that low switching rates are the result of the existence of two health insurance markets which are regulated differently: the basic health insurance market where risk selection is prohibited and the supplementary health insurance market where risk selection practices are allowed. We show that holding a supplementary contract reduces the probability of switching basic insurance provider for those with poor self-assessed health but has no effect on the switching behavior of enrollees in good/very good health. The efficient management of competition in the basic insurance market may suffer from a lack of adequate regulation in the supplementary market.

Suggested Citation

  • Brigitte Dormont & Pierre-Yves Geoffard & Karine Lamiraud, 2012. "Assurance maladie en Suisse : l'assurance supplémentaire nuit-elle à la concurrence sur l'assurance de base ?," PSE Working Papers hal-00795544, HAL.
  • Handle: RePEc:hal:psewpa:hal-00795544
    Note: View the original document on HAL open archive server: https://hal-essec.archives-ouvertes.fr/hal-00795544
    as

    Download full text from publisher

    File URL: https://hal-essec.archives-ouvertes.fr/hal-00795544/document
    Download Restriction: no

    Other versions of this item:

    More about this item

    Keywords

    assurance de base; assurance supplémentaire; Concurrence en assurance maladie; mobilité des assurés;

    JEL classification:

    • D41 - Microeconomics - - Market Structure, Pricing, and Design - - - Perfect Competition
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hal:psewpa:hal-00795544. 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: (CCSD). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    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.

    We have no references for this item. You can help adding them by using 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 RePEc Author Service 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.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.