Dynamic Effects of Health Insurance Reform

Jan Boone

No 20718, CEPR Discussion Papers from Centre for Economic Policy Research

Abstract: We estimate a dynamic structural model to assess the long-term health effects of demand-side cost-sharing. Using Eurostat regional data for 11 European countries (2008–2018), we track health transitions across cohorts defined by age, gender, income, and region. Our model shows that increased out-of-pocket payments reduce recovery rates, especially for low-income individuals. The resulting loss in (quality-adjusted) life years is significantly larger than what static estimates imply — up to twenty times higher for vulnerable groups. These findings highlight the importance of accounting for long-term dynamics in policy evaluation and underscore the unequal burden of cost-sharing on population health.

JEL-codes: I11 I13 I18 (search for similar items in EconPapers)
Date: 2025-10
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