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Nonparametric Bounds on the Effect of Deductibles in Health Care Insurance on Doctor Visits – Swiss Evidence

  • Gerfin, Michael

    ()

    (University of Bern)

  • Schellhorn, Martin

    ()

    (University of Kiel)

We evaluate the effect of the size of deductibles in the basic health insurance in Switzerland on the probability of a doctor visit. We employ nonparametric bounding techniques to minimise statistical assumptions. In order to tighten the bounds we consider three further assumptions: mean independence of an instrument, monotone treatment response, and monotone treatment selection. Under the first two assumptions we are able to bound the treatment effect of high deductibles compared to low deductibles below zero. Adding the third assumption allows to tighten the bounds further. We conclude that there is a negative treatment effect.

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Paper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 1616.

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Length: 22 pages
Date of creation: May 2005
Date of revision:
Publication status: published in: Health Economics, 2006, 15 (9), 1011-1020
Handle: RePEc:iza:izadps:dp1616
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  1. Charles F. Manski & John V. Pepper, 1998. "Monotone Instrumental Variables: With an Application to the Returns to Schooling," Virginia Economics Online Papers 308, University of Virginia, Department of Economics.
  2. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  3. Azeem Shaikh & Edward Vytlacil, 2005. "Threshold Crossing Models and Bounds on Treatment Effects: A Nonparametric Analysis," NBER Technical Working Papers 0307, National Bureau of Economic Research, Inc.
  4. Bhattacharya, Jay & Shaikh, Azeem M. & Vytlacil, Edward, 2012. "Treatment effect bounds: An application to Swan–Ganz catheterization," Journal of Econometrics, Elsevier, vol. 168(2), pages 223-243.
  5. Arnaud Chevalier & Gauthier Lanot, 2004. "Monotonicity and the Roy Model," Manchester School, University of Manchester, vol. 72(4), pages 560-567, 07.
  6. Winkelmann, Rainer, 2001. "Health Care Reform and the Number of Doctor Visits - An Econometric Analysis," IZA Discussion Papers 317, Institute for the Study of Labor (IZA).
  7. Gonzalez, Libertad, 2004. "Nonparametric Bounds on the Returns to Language Skills," IZA Discussion Papers 1098, Institute for the Study of Labor (IZA).
  8. Manski, C.F., 1996. "Monotone Treatment Response," Working papers 9604, Wisconsin Madison - Social Systems.
  9. Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Inequalities in Health Care Utilization in Switzerland over Time," IZA Discussion Papers 1316, Institute for the Study of Labor (IZA).
  10. Alberto Abadie & Guido W. Imbens, 2006. "Large Sample Properties of Matching Estimators for Average Treatment Effects," Econometrica, Econometric Society, vol. 74(1), pages 235-267, 01.
  11. Abadie, Alberto, 2003. "Semiparametric instrumental variable estimation of treatment response models," Journal of Econometrics, Elsevier, vol. 113(2), pages 231-263, April.
  12. John V. Pepper, 2000. "The Intergenerational Transmission Of Welfare Receipt: A Nonparametric Bounds Analysis," The Review of Economics and Statistics, MIT Press, vol. 82(3), pages 472-488, August.
  13. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456.
  14. James J. Heckman & Edward J. Vytlacil, 2000. "Instrumental Variables, Selection Models, and Tight Bounds on the Average Treatment Effect," NBER Technical Working Papers 0259, National Bureau of Economic Research, Inc.
  15. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
  16. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related inequalities in health care utilization in Switzerland over time," Diskussionsschriften dp0413, Universitaet Bern, Departement Volkswirtschaft.
  17. Manski, C.F., 1989. "Nonparametric Bounds On Treatment Effects," Working papers 8909, Wisconsin Madison - Social Systems.
  18. Martin Schellhorn, 2004. "Wählbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?," Diskussionsschriften dp0402, Universitaet Bern, Departement Volkswirtschaft.
  19. Donna K. Ginther, 2000. "Alternative Estimates of the Effect of Schooling on Earnings," The Review of Economics and Statistics, MIT Press, vol. 82(1), pages 103-116, February.
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