Cream Skimming by Health Care Providers and Inequality in Health Care Access: Evidence from a Randomized Field Experiment
Anna Werbeck (),
Ansgar Wübker () and
Nicolas Ziebarth ()
Additional contact information
Anna Werbeck: RWI
No 13100, IZA Discussion Papers from Institute of Labor Economics (IZA)
Using a randomized field experiment, we show that health care specialists cream-skim patients by their expected profitability. In the German two-tier system, outpatient reimbursement rates for both public and private insurance are centrally determined but are more than twice as high for the privately insured. In our field experiment, following a standardized protocol, the same hypothetical patient called 991 private practices in 36 German counties to schedule appointments for allergy tests, hearing tests and gastroscopies. Practices were 7% more likely to offer an appointment to the privately insured. Conditional on being offered an appointment, wait times for the publicly insured were twice as long than for the privately insured. Our findings show that structural differences in reimbursement rates lead to structural differences in health care access.
Keywords: health care inequality; reimbursement rates; health care access; discrimination; cherry picking; gastroscopy; audiometry; allergy test; allergists; otorhinolaryngologist; gastroenterologist (search for similar items in EconPapers)
JEL-codes: I14 I11 I18 (search for similar items in EconPapers)
Pages: 56 pages
New Economics Papers: this item is included in nep-eur, nep-exp, nep-hea and nep-ias
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1) Track citations by RSS feed
Downloads: (external link)
Working Paper: Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment (2020)
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:iza:izadps:dp13100
Ordering information: This working paper can be ordered from
IZA, Margard Ody, P.O. Box 7240, D-53072 Bonn, Germany
Access Statistics for this paper
More papers in IZA Discussion Papers from Institute of Labor Economics (IZA) IZA, P.O. Box 7240, D-53072 Bonn, Germany. Contact information at EDIRC.
Bibliographic data for series maintained by Holger Hinte ().