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Premium Subsidies and Social Insurance: Substitutes or Complements?


  • Mathias Kifmann

    () (Universitaet Hamburg)

  • Kerstin Roeder

    () (Universitaet Augsburg)


Premium subsidies have been advocated as an alternative to social health insurance. These subsidies are paid if expenditure on health insurance exceeds a given share of income. In this paper, we examine whether this approach is superior to social insurance from a welfare perspective. We show that the results crucially depend on the correlation of health and productivity. For a positive correlation, we find that combining premium subsidies with social insurance is the optimal policy.

Suggested Citation

  • Mathias Kifmann & Kerstin Roeder, "undated". "Premium Subsidies and Social Insurance: Substitutes or Complements?," Working Papers 2011/01, Hamburg Center for Health Economics, University of Hamburg.
  • Handle: RePEc:hch:wpaper:201101

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    References listed on IDEAS

    1. van de Ven, Wynand P. M. M. & van Vliet, Rene C. J. A. & Schut, Frederik T. & van Barneveld, Erik M., 2000. "Access to coverage for high-risks in a competitive individual health insurance market: via premium rate restrictions or risk-adjusted premium subsidies?," Journal of Health Economics, Elsevier, vol. 19(3), pages 311-339, May.
    2. BOADWAY, Robin & LEITE-MONTEIRO, Manuel & MARCHAND, Maurice & PESTIEAU, Pierre, 2001. "Social insurance and redistribution," CORE Discussion Papers 2001041, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    3. Friedrich Breyer & Martin Heineck & Normann Lorenz, 2003. "Determinants of health care utilization by German sickness fund members - with application to risk adjustment," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 367-376.
    4. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    5. Slemrod, Joel & Yitzhaki, Shlomo & Mayshar, Joram & Lundholm, Michael, 1994. "The optimal two-bracket linear income tax," Journal of Public Economics, Elsevier, vol. 53(2), pages 269-290, February.
    6. Gerdtham, Ulf-G. & Johannesson, Magnus, 2000. "Income-related inequality in life-years and quality-adjusted life-years," Journal of Health Economics, Elsevier, vol. 19(6), pages 1007-1026, November.
    7. Blomqvist, Ake & Horn, Henrik, 1984. "Public health insurance and optimal income taxation," Journal of Public Economics, Elsevier, vol. 24(3), pages 353-371, August.
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    Cited by:

    1. Pfarr, Christian & Schmid, Andreas, 2013. "The political economics of social health insurance: the tricky case of individuals’ preferences," MPRA Paper 44534, University Library of Munich, Germany.
    2. Jan Brosse & Mathias Kifmann, 2013. "Competition in Health Insurance and Premium Regulation," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(1), pages 21-26, 04.

    More about this item


    social insurance; health insurance; redistributive taxation; equity;

    JEL classification:

    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


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