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Public and private choice in UK health insurance

Author

Listed:
  • John Hall

    (Institute for Fiscal Studies)

  • Ian Preston

    () (Institute for Fiscal Studies and University College London)

Abstract

Many parts of the public sector coexist with private provision of similar services and in such circumstances we may expect to find interaction between public and private choices. Quality of publicly provided services will be a central influence on decisions whether to make use of private substitutes and use of private substitutes will feed back into attitudes towards the level of public spending. In this paper we present evidence using the British Social Attitudes Survey to show that individual take up of private medical insurance inhibits support for spending on the public health sector. Such effects have been shown to be appreciable and allowance for the joint determination of insurance decisions and attitudes magnifies the size of the estimated effects.

Suggested Citation

  • John Hall & Ian Preston, 1998. "Public and private choice in UK health insurance," IFS Working Papers W98/19, Institute for Fiscal Studies.
  • Handle: RePEc:ifs:ifsewp:98/19
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    File URL: http://www.ifs.org.uk/wps/wp9819.pdf
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    References listed on IDEAS

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    4. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    5. Gerhard Glomm & B. Ravikumar, 1998. "Opting out of publicly provided services: A majority voting result," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 15(2), pages 187-199.
    6. Besley, Timothy & Coate, Stephen, 1991. "Public Provision of Private Goods and the Redistribution of Income," American Economic Review, American Economic Association, vol. 81(4), pages 979-984, September.
    7. Casamatta, Georges & Cremer, Helmuth & Pestieau, Pierre, 2000. "Political sustainability and the design of social insurance," Journal of Public Economics, Elsevier, vol. 75(3), pages 341-364, March.
    8. John Hall & Ian Preston, 1998. "Tax price effects on attitudes to hypothecated increases," IFS Working Papers W98/06, Institute for Fiscal Studies.
    9. Lindsay Brook & John Hall & Ian Preston, 1997. "What drives support for higher public spending?," IFS Working Papers W97/16, Institute for Fiscal Studies.
    10. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
    11. Epple, Dennis & Romano, Richard E., 1996. "Ends against the middle: Determining public service provision when there are private alternatives," Journal of Public Economics, Elsevier, vol. 62(3), pages 297-325, November.
    12. Blackorby, Charles & Donaldson, David, 1988. "Cash versus Kind, Self-selection, and Efficient Transfers," American Economic Review, American Economic Association, vol. 78(4), pages 691-700, September.
    13. CASAMATTA, Georges & CREMER, Helmuth & PESTIEAU, Pierre, 1998. "On the political sustainability of redistributive social insurance systems," CORE Discussion Papers 1998038, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    14. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
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    Cited by:

    1. Andreas Bergh, 2008. "Explaining the Survival of the Swedish Welfare State: Maintaining Political Support Through Incremental Change," Financial Theory and Practice, Institute of Public Finance, vol. 32(3), pages 233-254.
    2. Chen, Alice J., 2012. "When does weight matter most?," Journal of Health Economics, Elsevier, vol. 31(1), pages 285-295.
    3. Ángel López-Nicolás & Marcos Vera-Hernández, 2002. "Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model for outpatient and inpatient episodes," Working Papers, Research Center on Health and Economics 632, Department of Economics and Business, Universitat Pompeu Fabra, revised Oct 2004.
    4. Joan Costa & Jaume Garcia, 2001. "Demand for private health insurance: Is there a quality gap?," Working Papers, Research Center on Health and Economics 531, Department of Economics and Business, Universitat Pompeu Fabra.
    5. Joan Costa & Jaume Garcia, 2003. "Demand for private health insurance: how important is the quality gap?," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 587-599.
    6. López Nicolás, Ángel & Vera-Hernández, Marcos, 2008. "Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model," Journal of Health Economics, Elsevier, vol. 27(5), pages 1285-1298, September.
    7. Hall, John & Preston, Ian, 2000. "Tax price effects on attitudes to hypothecated tax increases," Journal of Public Economics, Elsevier, vol. 75(3), pages 417-438, March.
    8. Carol Propper, 2001. "Expenditure on healthcare in the UK: a review of the issues," Fiscal Studies, Institute for Fiscal Studies, vol. 22(2), pages 151-183, June.

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