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Income and the Demand for Complementary Health Insurance in France

  • Michel Grignon

    ()

    (McMaster University, Department of Economics and Department of Health, Aging, and Society, Hamilton, Ontario, Canada)

  • Bidénam Kambia-Chopin

    ()

    (IRDES institut for research and information in health economics)

This paper examines the demand for complementary health insurance (CHI) in the non-group market in France and the reasons why the near poor seem price insensitive. First we develop a theoretical model based on a simple tradeoff between two goods: CHI and a composite good reflecting all other consumptions. Then we estimate a model of CHI consumption and empirically test the impact of potential determinants of demand for coverage: risk aversion, asymmetrical information, non-expected utility, the demand for quality and health, and supply-side factors such as price discrimination. We interpret our empirical findings in terms of crossed price and income elasticity of the demand for CHI. Last, we use these estimates of elasticity to simulate the effect of various levels of price subsidies on the demand for CHI among those with incomes around the poverty level in France. We find that the main motivation for purchasing CHI in France is protection against the financial risk associated with co-payments in the public health insurance scheme. We also observe a strong income effect suggesting that affordability might be an important determinant. Our simulations indicate that no policy of price subsidy can significantly increase the take-up of CHI among the near poor; any increase in the level of subsidy generates a windfall benefit for richer households.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT24IncomeDemandComplementHealthInsuranceFrance.pdf
File Function: First version, 2009
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Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT24.

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Length: 28 pages
Date of creation: Apr 2009
Date of revision: Apr 2009
Handle: RePEc:irh:wpaper:dt24
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  1. Barsky, Robert B, et al, 1997. "Preference Parameters and Behavioral Heterogeneity: An Experimental Approach in the Health and Retirement Study," The Quarterly Journal of Economics, MIT Press, vol. 112(2), pages 537-79, May.
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  4. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
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  10. Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219.
  11. Saliba, Berengere & Ventelou, Bruno, 2007. "Complementary health insurance in France Who pays? Why? Who will suffer from public disengagement?," Health Policy, Elsevier, vol. 81(2-3), pages 166-182, May.
  12. Amos Tversky & Daniel Kahneman, 1979. "Prospect Theory: An Analysis of Decision under Risk," Levine's Working Paper Archive 7656, David K. Levine.
  13. Cutler, David & McGarry, Kathleen & Finkelstein, Amy, 2008. "Preference Heterogeneity and Insurance Markets: Explaining a Puzzle of Insurance," Scholarly Articles 2640581, Harvard University Department of Economics.
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  16. Newhouse, Joseph P., 2006. "Reconsidering the moral hazard-risk avoidance tradeoff," Journal of Health Economics, Elsevier, vol. 25(5), pages 1005-1014, September.
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