The Effect of Private Health Insurance on Medical Care Utilization and Self-Assessed Health in Germany

Patrick Hullegie () and Tobias Klein
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Patrick Hullegie: Vrije Universiteit Amsterdam

No 5004, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance threshold. Here, premia are based on age and health, individuals may choose to what extent they are covered, and deductibles and co-payments are common. In this paper, we estimate the effect of private insurance coverage on the number of doctor visits, the number of nights spent in a hospital and self-assessed health. Variation in income around the compulsory insurance threshold provides a natural experiment that we exploit to control for selection into private insurance. We document that income is measured with error and suggest an approach to take this into account. We find negative effects of private insurance coverage on the number of doctor visits, no effects on the number of nights spent in a hospital, and positive effects on health.

Keywords: selection into insurance; natural experiment; measurement error; regression discontinuity design; medical care utilization; private health insurance (search for similar items in EconPapers)
JEL-codes: C31 I11 I12 (search for similar items in EconPapers)
Pages: 27 pages
Date: 2010-06
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ias
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (56)

Published - published in: Health Economics, 2010, 19 (9), 1048-1062

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Related works:
Journal Article: The effect of private health insurance on medical care utilization and self‐assessed health in Germany (2010)
Working Paper: The effect of private health insurance on medical care utilization and self-assessed health in Germany (2010)
Working Paper: The effect of private health insurance on medical care utilization and self-assessed health in Germany (2009)
Working Paper: The effect of private health insurance on medical care utilization and self-assessed health in Germany (2009)
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