Can a Deductible Kill? The Effect of Patient Cost-Sharing on Health

Padmaja Ayyagari (), Martin Salm () and Eric Sargent ()
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Padmaja Ayyagari: University of South Florida
Martin Salm: Tilburg University
Eric Sargent: Tilburg University

No 18420, IZA Discussion Papers from IZA Network @ LISER

Abstract: We study how health insurance deductibles affect healthcare spending and health using a regression discontinuity design and administrative data from the Netherlands. Exploiting an annual deductible reset, we compare patients admitted to the emergency room just before and after January 1. Patients admitted after the reset face zero marginal prices for care and incur 14\% higher annual healthcare costs. Despite substantially higher utilization, we find no effect on mortality or other health outcomes across income and health-risk groups. These results suggest that modest deductibles reduce healthcare spending without adverse health consequences.

Keywords: patient cost-sharing; health insurance; mortality; regression discontinuity design (search for similar items in EconPapers)
JEL-codes: D12 H51 I13 (search for similar items in EconPapers)
Date: 2026-03
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