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

Author

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  • 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

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    Citations

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    Cited by:

    1. Michael Gerfin & Boris Kaiser & Christian Schmid, 2015. "Healthcare Demand in the Presence of Discrete Price Changes," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1164-1177, September.
    2. Christine Sevilla-Dedieu & Nathalie Billaudeau & Alain Paraponaris, 2020. "Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment," Health Economics Review, Springer, vol. 10(1), pages 1-10, December.
    3. Kamila Cygan‐Rehm & Daniel Kuehnle & Michael Oberfichtner, 2017. "Bounding the causal effect of unemployment on mental health: Nonparametric evidence from four countries," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1844-1861, December.
    4. Rob J. M. Alessie & Viola Angelini & Jochen O. Mierau & Laura Viluma, 2020. "Moral hazard and selection for voluntary deductibles," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1251-1269, October.
    5. Martin Huber & Giovanni Mellace, 2015. "Sharp Bounds on Causal Effects under Sample Selection," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 77(1), pages 129-151, February.
    6. Stefan Boes, 2009. "Bounds on Counterfactual Distributions Under Semi-Monotonicity Constraints," SOI - Working Papers 0920, Socioeconomic Institute - University of Zurich.
    7. Véra Zabrodina & Mark Dusheiko & Karine Moschetti, 2020. "A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1566-1585, December.
    8. Jeremiah Richey, 2016. "An Odd Couple: Monotone Instrumental Variables and Binary Treatments," Econometric Reviews, Taylor & Francis Journals, vol. 35(6), pages 1099-1110, June.
    9. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
    10. Astrid Kiil, 2012. "Does employment-based private health insurance increase the use of covered health care services? A matching estimator approach," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 1-38, March.
    11. Marcel Bilger & Jean-Paul Chaze, 2008. "What Drives Individual Health Expenditure in Switzerland?," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 337-358, September.
    12. Philipp Hafner & Jörg C. Mahlich, 2016. "Determinants of physician's office visits and potential effects of co-payments: evidence from Austria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 192-203, July.
    13. Nicolas Ziebarth, 2014. "Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 41-67, March.
    14. Richard Peter & Sebastian Soika & Petra Steinorth, 2016. "Health Insurance, Health Savings Accounts and Healthcare Utilization," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 357-371, March.
    15. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2017. "A voluntary deductible in health insurance: the more years you opt for it, the lower your premium?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 209-226, March.
    16. Brent Kreider & Richard J. Manski & John Moeller & John Pepper, 2015. "The Effect of Dental Insurance on the Use of Dental Care for Older Adults: A Partial Identification Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 24(7), pages 840-858, July.
    17. Tsunao Okumura & Emiko Usui, 2014. "Concave‐monotone treatment response and monotone treatment selection: With an application to the returns to schooling," Quantitative Economics, Econometric Society, vol. 5, pages 175-194, March.
    18. Cygan-Rehm, Kamila & Kühnle, Daniel & Oberfichtner, Michael, 2017. "Bounding the Causal Effect of Unemployment on Mental Health: Nonparametric Evidence from Four Countries," IZA Discussion Papers 10652, Institute of Labor Economics (IZA).
    19. Astrid Kiil & Jacob Nielsen Arendt, 2017. "The effect of complementary private health insurance on the use of health care services," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 1-27, March.
    20. Kurt J. Lavetti & Thomas DeLeire & Nicolas R. Ziebarth, 2019. "How Do Low-Income Enrollees in the Affordable Care Act Marketplaces Respond to Cost-Sharing?," NBER Working Papers 26430, National Bureau of Economic Research, Inc.
    21. René Böheim & Thomas Leoni, 2014. "Firms' Sickness Costs and Workers' Sickness Absences," NBER Working Papers 20305, National Bureau of Economic Research, Inc.
    22. Alkalay, Adi & Eizenberg, Alon & Lahad, Amnon & Shurtz, Ity, 2018. "Physician workload and treatment choice: the case of primary care," CEPR Discussion Papers 13157, C.E.P.R. Discussion Papers.
    23. Stefan Pichler & Jan Ruffner, 2016. "Does it really make a difference? Health care utilization with two high deductible health care plans," KOF Working papers 16-404, KOF Swiss Economic Institute, ETH Zurich.
    24. Claudia Pütz & Christian Hagist, 2006. "Optional deductibles in social health insurance systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(4), pages 225-230, December.
    25. Richey, Jeremiah Alexander, 2012. "Essays on the identification of treatment effects with applications to the labor market," ISU General Staff Papers 201201010800003740, Iowa State University, Department of Economics.

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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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