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

Author

Listed:
  • Thierry Debrand

    () (IRDES institut for research and information in health economics)

  • Christine Sorasith

    () (IRDES institut for research and information in health economics)

Abstract

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.

Suggested Citation

  • Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
  • Handle: RePEc:irh:wpaper:dt34
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    File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT34OutPocketMaxRulesCompulsoryHealthCare.pdf
    File Function: First version, 2010
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    References listed on IDEAS

    as
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    Cited by:

    1. Catherine Pollak, 2012. "Employed and Happy despite Weak Health? Labour Market Participation and Job Quality of Older Workers with Disabilities," Working Papers DT45, IRDES institut for research and information in health economics, revised Mar 2012.
    2. Luiz Andrade & Catherine Sermet & Sylvain Pichetti, 2016. "Entry time effects and follow-on drug competition," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(1), pages 45-60, January.
    3. Caroline Berchet & Nicolas Sirven, 2012. "Cross-Country Performance in Social Integration of Older Migrants. A European Perspective," Working Papers DT46, IRDES institut for research and information in health economics, revised Mar 2012.
    4. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2012. "Sick Leaves: Understanding Disparities Between French Departments," Working Papers DT50, IRDES institut for research and information in health economics, revised Oct 2012.
    5. Catherine Pollak & Nicolas Sirven, 2012. "Active Ageing Beyond the Labour Market: Evidence on Work Environment Motivations," Working Papers DT48, IRDES institut for research and information in health economics, revised May 2012.

    More about this item

    Keywords

    Microsimulation; Health expenditure; Out-of-pocket payment.;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement

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