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Physicians' balance billing, supplemental insurance and access to health care

  • Izabela Jelovac

    (GATE Lyon Saint-Etienne - Groupe d'analyse et de théorie économique - CNRS : UMR5824 - Université Lumière - Lyon II - École Normale Supérieure - Lyon)

Some countries allow physicians to balance bill patients, that is, to bill a fee above the one that is negotiated with, and reimbursed by the health authorities. Balance billing is known for restricting access to physicians' services while supplemental insurance against balance billing amounts is supposed to alleviate the access problem. This paper analyzes in a theoretical setting the consequences of balance billing on the fees setting and on the inequality of access among the users of physicians' services. It also shows that supplemental insurance against the expenses associated with balance billing, rather than alleviating the access problem, increases it.

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Paper provided by HAL in its series Working Papers with number halshs-00787602.

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Date of creation: 12 Feb 2013
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Handle: RePEc:hal:wpaper:halshs-00787602
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  1. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
  2. Barros, Pedro Pita & Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2008. "Moral hazard and the demand for health services: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 27(4), pages 1006-1025, July.
  3. R. G. Beck, 1974. "The Effects of Co-Payment on the Poor," Journal of Human Resources, University of Wisconsin Press, vol. 9(1), pages 129-142.
  4. Yaari, Menahem E, 1987. "The Dual Theory of Choice under Risk," Econometrica, Econometric Society, vol. 55(1), pages 95-115, January.
  5. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
  6. Thomas C. Buchmueller & Agnes Couffinhal, 2004. "Private Health Insurance in France," OECD Health Working Papers 12, OECD Publishing.
  7. Eichner, Matthew J, 1998. "The Demand for Medical Care: What People Pay Does Matter," American Economic Review, American Economic Association, vol. 88(2), pages 117-21, May.
  8. SCHOKKAERT, Erik & VAN OURTI, Tom & DE GRAEVE, Diana & LECLUYSE, Ann, . "Supplemental health insurance and equality of access in Belgium," CORE Discussion Papers RP 2197, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  9. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
  10. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronin, 2002. "Access to Physician Services: Does Supplemental Insurance Matter? Evidence from France," NBER Working Papers 9238, National Bureau of Economic Research, Inc.
  11. Mathias Kifmann & Florian Scheuer, 2011. "Balance billing: the patients' perspective," Health Economics Review, Springer, vol. 1(1), pages 1-14, December.
  12. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471.
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