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Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity

  • Thierry Debrand

    ()

    (IRDES institut for research and information in health economics)

  • Christine Sorasith

    ()

    (IRDES institut for research and information in health economics)

Using the microsimulation model ARAMMIS, this study attempts to measure the impacts of introducing an out-of-pocket (OOP) maximum threshold, or a safety net threshold, on consumer copayments for health care financed by the abolition of the Long-term Illness Regime (ALD) in France. The analysis is based on a comparison of different safety net threshold rules and their redistributive effects on patients’ OOP payments. We attach particular importance to indicators that bring to light changes in OOP payment levels and measure their impact on the equity of OOP distribution. The first section outlines the French National Health System to provide a better understanding of the stakes involved in reforming the health care reimbursement rules under the Compulsory Health Care Insurance scheme. In the second section, we describe the hypotheses retained, the database and the microsimulation model. The final section presents key findings, measuring the impact of the reform at both individual and system levels.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT34OutPocketMaxRulesCompulsoryHealthCare.pdf
File Function: First version, 2010
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Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT34.

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Length: 30 pages
Date of creation: Nov 2010
Date of revision: Nov 2010
Handle: RePEc:irh:wpaper:dt34
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  1. Cambois, Emmanuelle & Jusot, Florence, 2010. "Monitoring Health Inequalities in France. A Short Tool for Routine Health Survey to Account for Lifelong Adverse Experiences," Economics Papers from University Paris Dauphine 123456789/7002, Paris Dauphine University.
  2. Abul Naga, Ramses H. & Lamiraud, Karine, 2009. "Catastrophic Health Expenditure and Household Well-Being," Department of Economics Working Papers 15975, University of Bath, Department of Economics.
  3. Zeynep Or & Florence Jusot & Engin Yilmaz, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Working Papers DT17, IRDES institut for research and information in health economics, revised Sep 2008.
  4. Mousquès, Julien & Bourgueil, Yann & Le Fur, Philippe & Yilmaz, Engin, 2010. "Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care," Health Policy, Elsevier, vol. 98(2-3), pages 131-143, December.
  5. Nicolas Sirven & Brigitte Santos-Eggimann & Jacques Spagnoli, 2008. "Comparability of Health Care Responsiveness in Europe using anchoring vignettes from SHARE," Working Papers DT15, IRDES institut for research and information in health economics, revised Sep 2008.
  6. Michel Grignon & Bidénam Kambia-Chopin, 2009. "Income and the Demand for Complementary Health Insurance in France," Working Papers DT24, IRDES institut for research and information in health economics, revised Apr 2009.
  7. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
  8. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
  9. Zeynep Or & Laure Com-Ruelle, 2008. "La qualité des soins en France : comment la mesurer pour l'améliorer ?," Working Papers DT19, IRDES institut for research and information in health economics, revised Dec 2008.
  10. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
  11. Valerie Albouy & Laurent Davezies & Thierry Debrand, 2009. "Dynamic Estimation of Health Expenditure: A new approach for simulating individual expenditure," Working Papers DT20, IRDES institut for research and information in health economics, revised Jan 2009.
  12. Michel Naiditch & Paul Dourgnon, 2009. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Working Papers DT22, IRDES institut for research and information in health economics, revised Mar 2009.
  13. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
  14. Julien Mousquès & Thomas Renaud & Olivier Scemama, 2008. "A refutation of the practice style hypothesis: the case of antibiotics prescription by French general practitioners for acute rhinopharyngitis," Working Papers DT18, IRDES institut for research and information in health economics, revised Oct 2008.
  15. Thierry Debrand & Nicolas Sirven, 2009. "What are the Motivations of Pathways to Retirement in Europe: Individual, Familial, Professional Situation or Social Protection Systems?," Working Papers DT28, IRDES institut for research and information in health economics, revised Oct 2009.
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