Risky health decisions under regulatory constraints: Abortion tourism in Switzerland

Annette Hofmann (), Julia K. Neumann () and Peter Zweifel ()
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Annette Hofmann: St. John’s University
Julia K. Neumann: University of Hamburg
Peter Zweifel: University of Zurich

Journal of Risk and Uncertainty, 2019, vol. 59, issue 3, No 1, 203-237

Abstract: Abstract This study provides both a behavioral model and empirical evidence on the risky search for a health service across jurisdictions that differ in their regulatory policies. The health service in question is a particularly sensitive one, an abortion, and the jurisdictions are the 26 cantons of Switzerland. Using Swiss health insurance data, theoretical predictions are confirmed to a considerable degree: (1) Women who derive a particularly high benefit from an abortion (and concealing it) are less discouraged by strict local enforcement than others; (2) A substantial share of abortions may be concealed by contrived medical coding, and (3) Conservative cantons with a preference for stringent implementation of federal abortion regulation export the problem to more liberal ones, resulting in preference-based migration. The analysis implies a difficult trade-off for policy: To curtail abortion tourism, the cantons would have to be mandated to implement the pertinent federal regulation in a uniform way; this would, however, neglect important regional differences in preferences.

Keywords: Roe v. Wade; Abortion; Social health insurance; Migration; D47; G22; I18; J13; K42 (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s11166-019-09319-z

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