Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal

Aida Isabel Tavares and Inês Marques
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Inês Marques: CEISUC, Centre of Studies and Research in Health of the University of Coimbra

The European Journal of Health Economics, 2021, vol. 22, issue 1, No 10, 153 pages

Abstract: Abstract The Portuguese health system has the peculiar characteristic of being a Beveridge–Bismarck type aiming at universal coverage. On top of the national health system coverage, there is a second coverage provided to some professionals, plus a third layer of coverage that can be acquired by taking out voluntary private health insurance. The aim of this work is to ascertain whether people benefiting from supplemental multi-layer health coverage (on top of the existing National Health System) have more consultations, either with general practitioners or with specialists, and enjoy better health status. We used data from the National Health Survey from 2014 to estimate a recursive system of ordered probits. The main results confirm that multi-layer health coverage is correlated with the use of more specialist consultations, but not with more GP consultations. It is also correlated with better health status. These results may indicate the existence of moral hazard, induced demand and/or 'access effect'. Regarding policy matters, the measures aimed to reduce waiting times, improve patient choice, and increase access could counteract such results and mitigate the potential inequity of access and health status, and also excessive use of medical services that can happen under double health coverage.

Keywords: Health insurance; Coverage; Utilization; Health (search for similar items in EconPapers)
JEL-codes: I11 I13 (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s10198-020-01242-4

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