Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

Minke Remmerswaal, Jan Boone (), Michiel Bijlsma and Rudy Douven ()
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Jan Boone: CPB Netherlands Bureau for Economic Policy Analysis
Rudy Douven: CPB Netherlands Bureau for Economic Policy Analysis

No 367, CPB Discussion Paper from CPB Netherlands Bureau for Economic Policy Analysis

Abstract: Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure. This is a revised version of the paper (Januray 2019). Compared to the previous version of December 2017, this version includes additional analyses, assumption tests and a difference-in-differences framework.

JEL-codes: C23 D12 H51 I12 I13 (search for similar items in EconPapers)
Date: 2017-12
New Economics Papers: this item is included in nep-hea and nep-ias
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Citations: View citations in EconPapers (3)

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