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Copayments in the German Health System – Do They Work?

  • Boris Augurzky


  • Thomas Bauer


  • Sandra Schaffner


This paper examines the effect of copayments on doctor visits using the German health care reform of 2004 as a natural experiment. In January 2004, copayments of 10 euros for the first doctor visit in each quarter have been introduced for all adults in the statutory health insurance. Individuals covered by private health insurance as well as youths have been exempted from these copayments. We use them as control groups in a difference-in-differences approach to identify the causal impact of these copayments on doctor visits. In contrast to expectations and public opinion our results indicate that there are no statistically significant effects of the copayments on the decision of visiting a doctor.

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Paper provided by Rheinisch-Westfälisches Institut für Wirtschaftsforschung in its series RWI Discussion Papers with number 0043.

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Length: 16 pages
Date of creation: Aug 2006
Date of revision:
Handle: RePEc:rwi:dpaper:0043
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  1. Ashenfelter, Orley C, 1978. "Estimating the Effect of Training Programs on Earnings," The Review of Economics and Statistics, MIT Press, vol. 60(1), pages 47-57, February.
  2. Marcus Tamm & Harald Tauchmann & Jürgen Wasem & Stefan Gre�, 2007. "Elasticities of market shares and social health insurance choice in germany: a dynamic panel data approach," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 243-256.
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