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

Author

Listed:
  • Gerfin, Michael

    (University of Bern)

  • Schellhorn, Martin

    (University of Kiel)

Abstract

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.

Suggested Citation

  • Gerfin, Michael & Schellhorn, Martin, 2005. "Nonparametric Bounds on the Effect of Deductibles in Health Care Insurance on Doctor Visits – Swiss Evidence," IZA Discussion Papers 1616, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp1616
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    References listed on IDEAS

    as
    1. 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, July.
    2. Martin Schellhorn, 2004. "W hlbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?," Diskussionsschriften dp0402, Universitaet Bern, Departement Volkswirtschaft.
    3. Abadie, Alberto, 2003. "Semiparametric instrumental variable estimation of treatment response models," Journal of Econometrics, Elsevier, vol. 113(2), pages 231-263, April.
    4. Arnaud Chevalier & Gauthier Lanot, 2004. "Monotonicity and the Roy Model," Manchester School, University of Manchester, vol. 72(4), pages 560-567, July.
    5. 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.
    6. Rainer Winkelmann, 2004. "Health care reform and the number of doctor visits-an econometric analysis," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 455-472.
    7. 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.
    8. 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, January.
    9. Charles F. Manski, 1997. "Monotone Treatment Response," Econometrica, Econometric Society, vol. 65(6), pages 1311-1334, November.
    10. 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 of Labor Economics (IZA).
    11. 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.
    12. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related health inequalities in Switzerland over time," Diskussionsschriften dp0414, Universitaet Bern, Departement Volkswirtschaft.
    13. Libertad González, 2005. "Nonparametric bounds on the returns to language skills," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 20(6), pages 771-795.
    14. 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.
    15. 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.
    16. Manski, Charles F, 1990. "Nonparametric Bounds on Treatment Effects," American Economic Review, American Economic Association, vol. 80(2), pages 319-323, May.
    17. 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.
    18. 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 251-277, June.
    19. Rainer Winkelmann, 2002. "Health Care Reform and the Number of Doctor Visits � An Econometric Analysis," SOI - Working Papers 0210, Socioeconomic Institute - University of Zurich.
    20. Charles F. Manski & John V. Pepper, 2000. "Monotone Instrumental Variables, with an Application to the Returns to Schooling," Econometrica, Econometric Society, vol. 68(4), pages 997-1012, July.
    21. 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.
    22. Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Health Inequalities in Switzerland over Time," IZA Discussion Papers 1346, Institute of Labor Economics (IZA).
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    More about this item

    Keywords

    health insurance; bounds; treatment effects;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I19 - Health, Education, and Welfare - - Health - - - Other

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